Mandatory: Student Medical & Emergency Information


The following form uses an E-signature which is the digital equivalent of a handwritten signature or stamped seal.  According to the U.S. Federal ESIGN Act passed in 2000, an electronic signature is an “electronic sound, symbol, or process, attached to or logically associated with a contract or other record and executed or adopted by a person with the intent to sign the record.”  In layman’s terms, an electronic signature, often referred to as an e-signature, is a person’s electronic expression of his or her agreement to the terms of a particular document.   If you have questions Please email Trish Franks at natchezbendequestrianteam@gmail.com


 Contact Information


Emergency Contacts


About The Student


Emergency Actions

I, give permission to The Trish Franks Riding School, LLC to contact 911 to transport  to your choice of hospital in the event of accident in the event that you cannot be contacted. Emergency numbers are on the back of name badges for immediate contact.  

SIGNED: Parent or Legal Guardian
Date:   

 

Leave this empty:

Signed by Patricia Franks
Signed On: February 29, 2016

Trish Franks Riding School https://natchezbend.com
Signature Certificate
Document name: Mandatory: Student Medical & Emergency Information
Unique Document ID: 397f933b5d82db883b77a2f2a2c42421976091f5
Timestamp Audit
2016-02-02 04:54:52 EDTMandatory: Student Medical & Emergency Information Uploaded by Patricia Franks - trish.franks.riding.school@gmail.com IP 67.177.166.173