2018 Soccer Camp Registration

Camper Information

Camper's Full name *

Team/Club

Only required if registering for the Team discount

T-shirt Size

Age *

Gender *

Male

Female

Street Address *

City *

State *

Zip *

Insurance Information

Please note any medical conditions that we should be aware of

Insurance Provider *

Insurance Policy Number *

Health And Insurance Information

I certify that the applicant is physically able to participate in boys basketball camp and has adequate health insurance coverage. I hereby authorize the directors of the camp to act according to their best judgment in any emergency requiring medical attention.

Insurance Agreement *

I have read, understand, and agree to the above.

Assumption of Risk and Release of Liability

Parent/guardian First Name *

Parent/guardian Last Name *

Parent/guardian Email

Parent/guardian Cell *

THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS – READ IT CAREFULLY

I have applied to participate in the Lawrence University program described as the 2018 Spring Clinics (“Program”) during the period June 18 - July 20, 2018. I acknowledge that the Program is voluntary and may involve certain risks, including those described below.

I understand that by participating in the Program, I will engage in: strenuous physical activity with other participants, competition, recreational activities and, if applicable, reside in student dormitories and travel off campus. I acknowledge that these activities present certain inherent risks that are beyond Lawrence University’s control.

I choose to participate in the Program understanding its associated risks, and knowingly and voluntarily assume all risks of collision, injury, illness, death or damage to or loss of my property that may occur while engaging in sports, recreation and any other activities arising out of or related to the Program.

I understand that I may discontinue participation at any time in light of the risks.

I hereby forever release Lawrence University, its trustees, officers, employees, and agents (the “Released Parties”), from liability for any negligent act or omission arising from my participation in the Program, including related costs, damages, claims or assertions to which I or my family, estate, or heirs may claim against the Released Parties.

This Assumption of Risk and Release of Liability shall be construed in accordance with the laws of the State of Wisconsin, which shall be the forum for any lawsuits filed under or incident to this Release or the Program.

Liability Agreement *

I have read, understand, and agree to the above.

Photo Agreement

I/we grant permission for photos/images of minor to be published in future Lawrence University Soccer Camp brochures, website or advertisements.

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Sections

Camp Dates

Registration Deadline

Health And Insurance Information