I certify that I do, in the event that I become a participating volunteer of Texas American Legion Boys State to be held in Austin, Texas, hereby consent and grant permission, should the necessity of medical care arise, to the furnishing of medical treatment and hospital services as ordered/recommended by a qualified attending physician/nurse, including the administration of an anesthetic, laboratory procedures, medical/surgical treatment, x-ray or other hospital services. Consent is hereby granted to the attending physician(s), hospital(s), and/or clinic(s) to release necessary medical information to our local doctors and for use in claims for insurance coverage.
This will further certify that I, in consideration of the benefits to be derived by me in the event that I am a member of the Texas American Legion Boys State to be held in Austin, Texas, do hereby release and discharge The American Legion, its officers, agents, instructors, and employees from any and all clams, demands, damages, suits, actions or causes of action which I may, can, or shall have by reason of any illness, injury, or accident incurred or suffered while traveling to or from, attending at, or participating in Texas American Legion Boys State program from the time of my departure from home until my return thereto.
I also understand that this form also serves to establish my consent and permission to be photographed or audio- or video-taped for use by the Texas American Legion Boys State in public media presentation, including online and in printed materials.
I recognize that TXBS is a very active program. In the next section are listed key attributes that will be required during the week long program. By signing below, I certify that I am physically fit and able to lead and participate fully in this program.
1) I acknowledge and confirm that I am able to walk in aggregate 6-8 miles per day in 90-100 degree heat (average distance of walking approximately 3/4 - 1 mile at a time).
2) I acknowledge and confirm that I am able to walk an aggregate of 20 flights of stairs per day (average is 4-6 flights climbed at a time).
3) I acknowledge and confirm that I may also choose to participate in supervised athletic activities, including volleyball, basketball, and/or dodgeball, and in doing so, be in solid physical shape for these events.