2015 jhs team camp registration and waiver form edited for website
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1) The document is an individual program registration and release form for the Jefferson Lady Dragons Summer Shootout Team Camp. 2) It collects information such as the participant's name, birthdate, grade, address, emergency contact, and parent's signature. 3) By signing, the parent gives approval for their child to participate in activities, assumes all risks, waives their right to make claims, and allows coaches to obtain medical help in case of emergency.
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- 1. INDIVIDUAL PROGRAM REGISTRATION & RELEASE FORM Jefferson Lady Dragons Summer Shootout TEAM CAMP Team: __________________________________________________________ Participants Name: ________________________________________________________________ Birthdate: ______________________ Grade: ________ Street Address: _____________________________________________________________________________ _ City/State/Zip: _____________________________________________________________________________ _ Family Info: Primary Contact ____________________ _____________________ Phone h___________________ w____________________ c______________________________ Parents Email Address: ________________________________________________________ Emergency Contact: Name: ______________________________ Phone: ___________________________ Parental Release --- Please Read Carefully I hereby give approval for the participation of my child in the Jefferson High School Girls Varsity Team Camp with team listed above and assume all risks and hazards incidents to such participation, including transportation to and from all activities. I waive, release, absolve, indemnify and agree to hold harmless the Jefferson High School BOE and umbrella athletics organization, affiliated associations, organizers, officers, coaches, parents, participants and officials from any claim arising out of injury to my child. I hereby give permission for Jason Gibson or any member of the Jefferson High School Basketball Staff to obtain medical services for my child in case of medical emergency or injury. I declare that my child or I are physically fit and have the skill level required to participate in this particular event. I also understand that my child or I may be required to leave the facility should my child or I exhibit undesirable conduct Signature: ____________________________________ Date: ______________________________