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Iowa 4H Medical Information/Release Form (Club Member) Year Keep original in County Office. PARTICIPANT INFORMATION Participants Name Permanent Address City, State, Zip Name of Club Date of Birth
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How to fill out iowa 4-h medical informationrelease
How to fill out Iowa 4-H Medical Information Release:
01
Fill in your personal information: Start by providing your full name, address, phone number, and email address. Make sure to double-check the accuracy of this information.
02
Complete emergency contact details: Fill in the name, relationship, phone number, and address of at least two emergency contacts. These contacts should be individuals who can be reached in case of any medical emergency or if any important information needs to be conveyed.
03
Provide medical information: This section requires you to provide details about your medical history. Fill in information such as any allergies, medications you are currently taking, existing medical conditions, and any other relevant medical information.
04
Consent and release: Read the consent and release section carefully. By signing this document, you are authorizing medical personnel to administer necessary medical treatment in case of an emergency during any 4-H event or activity. Sign and date the document in the designated space.
05
Health insurance information: Provide your health insurance details, including the name of the insurance company and your policy number. This information is vital for obtaining proper medical treatment in case of an emergency.
Who needs Iowa 4-H Medical Information Release:
01
All participants: Any individual who wants to participate in Iowa 4-H activities or events, including 4-H members and volunteers, should complete the Iowa 4-H Medical Information Release form. It ensures that medical information is readily available in case of emergency situations.
02
Parents or guardians of minors: If a participant is a minor, the parent or legal guardian must fill out and sign the Iowa 4-H Medical Information Release form on their behalf.
03
Event organizers and leaders: Event organizers and leaders should also be aware of the Iowa 4-H Medical Information Release form and ensure that all participants have completed and submitted the form before engaging in any 4-H activities or events for the safety and well-being of all individuals involved.
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