2019 Washington Youth Tour Electric Cooperatives of Arkansas

Medical Information and Release Form
Your sponsoring electric cooperative, Arkansas Electric Cooperative Corporation (AECC), and the National Rural Electric Cooperative Association (NRECA) collect the information contained in this form to provide or arrange first aid and other medical treatments for participating students of the Electric Cooperative Youth Tour to Washington. We reserve the right to refuse participation to your child in the tour in the event you refuse to provide the requested information. The information collected will be kept by AECC and NRECA staff and made available to medical staff in the case of an accident or emergency. This information is not shared for any other purpose.

Do you have medical insurance