Informed Consent and Acknowledgement:
Throughout the Coaching Program, students may be photographed and/or
recorded to promote Canada Super Spelling Bee (CSSB) programs and events.
Students may be featured in print and/or social media to increase awareness for CSSB.
These types of media include: brochures, web, social media, and other types of media.
I, the undersigned, authorize CSSB and its employees and representatives’ permission to print,
photograph, and record me for use in audio, video, film, or other media platforms.
I hereby give my approval for my child’s participation in any and all activities prepared
by Canada Super Spelling Bee during the selected program. In exchange for the acceptance of
said child’s candidacy by Canada Super Spelling Bee Inc., I assume all risk and hazards
incidental to the conduct of the activities, and release, absolve and hold harmless Canada
Super Spelling bee and all its respective officers, agents, and representatives from any and
all liability for injuries to said child arising out of traveling to, participating in, or
returning from selected program sessions.
In case of injury to said child, I hereby waive all claims against Canada Super Spelling Bee.
Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and,
if applicable, owners and lessors of premises used to conduct the event. There is a risk of
being injured that is inherent in all physical activities, including basketball. Some of these
injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Download Standard Media Consent & Release Form
Medical Release and Authorization:
As Parent and/or Guardian of the named student, I hereby authorize
the diagnosis and treatment by a qualified and licensed medical professional,
of the minor child, in the event of a medical emergency, which in the opinion
of the attending medical professional, requires immediate attention to prevent
further endangerment of the minor’s life, physical disfigurement, physical impairment,
or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical
or minor surgical treatment, x-ray examination and immunizations for the named student.
In the event of an emergency arising out of serious illness, the need for major surgery,
or significant accidental injury, I understand that every attempt will be made by the
attending physician to contact me in the most expeditious way possible. This authorization
is granted only after a reasonable effort has been made to reach me.
Permission is also granted to the Canada Super Spelling Bee and its affiliates including Directors,
Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission
to the medical facility.
Release authorized on the dates and/or duration of the registered season.
This release is authorized and executed of my own free will, with the sole purpose of authorizing
medical treatment under emergency circumstances, for the protection of life and limb of the named minor child,
in my absence.