[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-502179-105":59,"doc-detail-502179-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","ccat-swimming-emergency-covid-fillable-form-release-emergency-information","CCAT Swimming Emergency & Covid Fillable Form - Release & Emergency Information","","CCAT Swimming emergency and release form collects athlete and parent/guardian contact details, swimmer school and birthdate, and medical history including allergies and current conditions. It authorizes emergency medical treatment, including exams, anesthesia, diagnosis, and hospital care, and permits custody handoff to the authorized agent after treatment completion. The form also includes a participation and risk waiver for swimming and water polo and consent for use of the child’s photos on team materials, with the authorization period running through December 31, 2023.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/ccat-swimming-emergency-covid-fillable-form-release-emergency-information/502179/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/ccat-swimming-emergency-covid-fillable-form-release-emergency-information/502179.png","ImageObject",300,407,{"name":92,"@type":93},"Asher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-10-03",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What information does the CCAT Swimming form collect from the athlete and parents/guardians?","Question",{"text":112,"@type":113},"It collects the athlete’s personal details, contact information for parents/guardians, swimmer school, birthdate, and medical history such as allergies, medications, and health conditions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What does the consent section authorize in an emergency?",{"text":117,"@type":113},"It authorizes CCAT Swimming’s representative to consent in advance to x-ray, examinations, anesthetic, medical or surgical diagnosis/treatment, and hospital care as advised by a licensed physician.",{"name":119,"@type":110,"acceptedAnswer":120},"What does the release agreement require participants/parents to understand and agree to?",{"text":121,"@type":113},"It explains risks inherent in swimming and water polo and releases and holds harmless the listed organizations and their representatives from liability for injuries, damages, or wrongful death related to participation and instruction.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},502179,1791807910,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24,"preview_page_count":4},687197207639,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","CCAT Swimming ATHLETE LAST NAME:   \nRELEASE & EMERGENCY INFORMATION FIRST NAME:  MID. NAME:   \n(Please use a pen and print info) HOME PHONE: (  )   \nCircle pool: PIERCE BIRMINGHAM Swimmer’s School:   \nParent’s EMAIL address:   Athlete’s Birthdate:   /  /  Age:   \nPediatrian’s Name:  Pedriatrian’s Phone \\#:  Insurance Carrier:   Policy/Group \\#:   \nSwimmer’s Medical History (any allergies, current medications, health problems, i.e. asthma, seizures, past injuries):  \nMother’s Name:  Driver’s Lic\\#:  Mom’s Cell:(  )  Text: Yes No Father’s Name:  Driver’s Lic\\#:  Dad’s Cell: (  ) Text: Yes No Athlete’s cell: (  ) Text: Yes No  \nHome Street Address:  City:  Zip:   \nIn case of emergency, if parents not reachable, call Friend/Relative:  Phone(   )   \nCONSENT FOR EMERGENCY TREATMENT  \nI (We) the undersigned parent(s) of   , a minor, do hereby authorize the representative of CCAT Swimming, as my agent(s) to consent to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of, any physician licensed under the provisions of Medical Practice Act on the medical staff of any accredited hospital, whether such diagnosis or treatment is rendered at the office of the physician or at the hospital.  \nI (We) understand that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, but is given to provide authority and power to my agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician in the exercise of his/her best judgement may deem advisable.  \nThis authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California.  \nI hereby authorize any hospital which has provided treatment to the above named minor pursuant to the provisions of Section 25.8 of the Civil Code of California to surrender physical custody of such minor to my agent(s) upon completion of treatment. This authorization is given pursuant to Section 1238 of the Health and Safety Code.  \nThis authorization shall remain in place from the signature through December 31, 2023 , unless sooner revoked in writing to my agent(s) . I hereby waive on behalf or myself and the above mentioned child any liability of CCAT Swimming Inc. , Southern California Swimming, U.S.A Swimming, Los Angeles Community Colleges, L.A. Pierce College, Los Angeles Unified School District, Birmingham Community Charter High School and any of its agents or employees rising out of such medical treatment.  \nSignature of Parent:  Date:   \nRELEASE AGREEMENT  \nI understand that there are risks and dangers inherent in participating and/or receiving instruction and training in swimming and/or water polo, including, without limitation, injuries resulting from physical contact with other athletes and/or equipment in the pool or pool area, slipping on the deck or injury from any part of the dryland exercise equipment (weights, medicine balls, stretch cords), the starting blocks, and in the locker room and/or showers. I also understand that in order to be allowed to participate and/or receive coaching instruction in aquatics I give up my rights to hold CCAT Swimming, Inc. , Southern California Swimming Inc. , U.S.A. Swimming, Crespi Carmilte High School, Los Angeles Unified School District, Birmingham Community Charter High School, Los Angeles Community Colleges, L.A. Pierce College , and Valley Cross Fit liable for any damage which I or my child may suffer while participating and/or receiving instruction, coaching and training in dryland exercises, swimming and/or water polo.  \nKnowing this, and in consideration of being permitted to participate and/or receive instruction in swimming and/or water polo , I hereby voluntarily release and hold harmless not only the entities set forth in the paragraph above, but also the officers, agents, coaches, ","cbCaissTDJYFWTlW","https://ap.wps.com/l/cbCaissTDJYFWTlW","pdf",245079,"English","# Release & Emergency Information\n## Consent for Emergency Treatment\n## Release Agreement\n## Hold Harmless Waiver","[{\"question\":\"What information does the CCAT Swimming form collect from the athlete and parents/guardians?\",\"answer\":\"It collects the athlete’s personal details, contact information for parents/guardians, swimmer school, birthdate, and medical history such as allergies, medications, and health conditions.\"},{\"question\":\"What does the consent section authorize in an emergency?\",\"answer\":\"It authorizes CCAT Swimming’s representative to consent in advance to x-ray, examinations, anesthetic, medical or surgical diagnosis/treatment, and hospital care as advised by a licensed physician.\"},{\"question\":\"What does the release agreement require participants/parents to understand and agree to?\",\"answer\":\"It explains risks inherent in swimming and water polo and releases and holds harmless the listed organizations and their representatives from liability for injuries, damages, or wrongful death related to participation and instruction.\"}]","CCAT Swimming Emergency & Covid Fillable Form - Release & Emergency Information | PDF",1791030096]