Wells Gray Outdoors Club
BC Rabbits Cross-Country Skiing Medical Form

This form must be completed for every participant in the Rabbits program.

Medical Problems: Please note any health-problems, including allergies, injuries (serious or minor), handicaps, emotional difficulties, behavioural problems or other factors which may limit your child’s full participation in the program.

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Medications: Please list all medications, dosages, any reactions, and special instructions.

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This is my permission for the official in charge to provide medical attention for my child / ward ____________________ in the event of an emergency, without the necessity for my prior approval. It is understood that, if an emergency occurs, a responsible adult will ensure that my child / ward receives proper medical attention, and that arrangements will be made for his / her return home, if necessary. I understand that I will be notified as soon as possible if this authority is exercised. I hereby authorize release of this form to any medical personnel who may require this information.