EXHIBIT C RELEASE, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT
|
|
- Sharlene Long
- 6 years ago
- Views:
Transcription
1
2 EXHIBIT C RELEASE, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT Attendee Name: Parent/Guardian Name: Effective Date:, 20 Camp Session Dates: Coach: Company: Full Name Full Legal Name If no company, please indicate NONE. Camp (Describe camp, e.g., by sport, participants, brand, etc.): In consideration for the Attendee being permitted to enroll, attend and participate in the Camp ( Activity ), I hereby waive and release forever any and all rights and claims I may have against Villanova University, its trustees, officers, agents, employees, and, from and against any and all liability for any harm, injury, damage, claims, demands, actions, costs, and expenses of any nature which Attendee may have or which may hereafter accrue to Attendee, arising out of or related to any loss, damage, or personal injury, that may be sustained by Attendee or by any property belonging to Attendee, whether caused or allegedly caused by or resulting from the negligence (whether characterized as negligence or gross negligence) on the part of Villanova University, its trustees, officers, employees, agents, Company, Coach, or otherwise, while Attendee is in, on, upon, or in transit to or from the premises where the Activity, or any adjunct to the Activity, occurs or is being conducted. If any portion of this provision is determined to be unenforceable, the remainder shall still be enforceable to the fullest extent permissible. I hereby accept, understand, and assume the risk of injury in this Activity, due to the physical nature of the Activity, including, without limitation, falls, contact with other participants, and being injured by thrown or batted balls or other sports equipment. I agree that Attendee will follow all instructions and to wear all necessary, recommended, and appropriate protective gear and equipment. I understand that this Activity is neither administered nor sponsored by Villanova University and that Company and/or Coach is providing this Camp outside the scope of his/her employment with the University. I hereby release, hold harmless, and indemnify Villanova University, its trustees, its officers, its employees, its agents, Company and Coach from any and all claims and liability arising out of the Activity. I also hereby grant permission for the use of Attendee s image in any photographs, videos, sound recordings or other media containing my image ( Images ) made in connection with the Activity. The Images may be used without restriction for the benefit of Villanova or the Camp in any and all publications or media, in any form, including on any Villanova web site or social media site, without further consideration, and I acknowledge Villanova s right to so use the Images at its discretion. I hereby irrevocably waive and release any claims against Villanova University, Company or Coach in connection with the use of the Images. Signature of Attendee: If Attendee is under 18, this must be signed by a Parent or Legal Guardian of Attendee: I hereby agree to all of the above conditions, including the waiver and release of claims and release of Villanova University, Company and Coach from liability and the permission to photograph Attendee and use such Images. Signature of Parent or Guardian: 11
3
4
5
6
7
8
9
10
11 Villanova(Softball(Camp(Rules(and( Regulations! 1.The&&possession&or&use&of&Alcohol&and&other&drugs,&Fireworks,&gund&and&other& weapons&is&prohibited.& 2.&The&operation&of&a&motor&vehicle&by&Minors&is&prohibited&while&participating&in& the&program& 3.&Participants&must&park&vehicles&in&accordance&with&University&parking& regulations& 4.&Minor&may&leave&the&University&during&camp&hours&only&with&written&consent& from&a&parent&or&legal&guardian&and&that&person&must&come&to&the&camp&director& to&identify&themselves&to&pick&the&child&up.&& 5.&No&child&will&be&released&after&camp&until&the&parent&comes&to&the&field&to&pick& up&their&child.&there&is&a&lot&of&construction&and&we&need&everyone&to&be&safe.& 6.&No&theft&or&violence,&including&sexual&abuse&or&harassment&will&be&tolerated.& 7.&Hazing&of&any&kind&is&prohibited.&Bullying,&including&verbal,&physical&and&cyber& bullying&is&prohibited.& 8.&No&use&of&tobacco&products&will&be&tolerated&anywhere&on&campus.& 9.&Misuse&or&damage&of&University&property&is&prohibited.&Charges&will&be&assessed& for&those&responsible.& 10.&If&any&of&the&above&rules&are&violated&the&parents&will&be¬ified&to&come&and& pick&up&the&student&from&camp.&no&refunds&will&be&given.&& 11.&No-camper-is-allowed-to-leave-the-confines-of-the-field&and&playing&areas& beyond&the&fenced&area&without&letting&a&counselor&know&and&must&be& accompanied&by&a&counselor.&you&may¬&go&with&a&friend!!!maria!dibernardi! !!or!jess!vetock! !camp!directors&
12 ! I!hearby!acknowledge!that!I!have!read!the!camp!rules!and!regulations!and!have! reviewed!them!together!with!my!child/parent/guardian!! Parent!Signature!Date! Camper!Signature Date!! Please!bring!this!to!registration!along!with!the!other!documents!!
ALL SPORTS STRENGTH AND CONDITIONING CAMP
U n i v e r s i t y o f W a s h i n g t o n H u s k i e s ALL SPORTS STRENGTH AND CONDITIONING CAMP SATURDAY JUNE 1st, 2013 9-11am: grades 6-8 11:30-1:30pm; grades 9-10 2-4pm: grades 11-12 It s back for
More informationTULANE UNIVERSITY ATHLETICS CAMPS Physical Examination Information. Date / / Name of Camp: Name of Participant: Age: Birth date: / /
Physical Examination Information Date / / Name of Camp: Name of Participant: Age: Birth date: / / Each participant must EITHER attach a copy of a physician conducted sports examination applicable to this
More information2018 Bowdoin Summer Art Camp Registration
2018 Bowdoin Summer Art Camp Registration Hours and Location Bowdoin Summer Art Camp will run for four weeks from June 25 th through July 27 th, with no classes being held 4 th of July week. The times
More informationFlorida Waiver (Commercial) (All parents of minors who are Florida residents must sign both the Florida commercial and non-commercial waivers)
Florida Waiver (Commercial) (All parents of minors who are Florida residents must sign both the Florida commercial and non-commercial waivers) (Commercial Activity Providers) WAIVER AND RELEASE OF LIABILITY
More information2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet
2018 Jr. Celtics School Vacation Week Two Day Clinic Registration Packet For more information call 617-399-8432 or email Sam at: jrceltics@celtics.com When: Monday, February 19, 2018 & Tuesday, February
More informationYouth Camp Waiver RELEASE, WAIVER OF LIABILITY, COVENANT NOT TO SUE AND LIKENESS RELEASE
Youth Camp Waiver RELEASE, WAIVER OF LIABILITY, COVENANT NOT TO SUE AND LIKENESS RELEASE (READ CAREFULLY BEFORE SIGNING) I,, hereby acknowledge my awareness that my child s participation in the University
More informationCULINARY CAMP. Contact and Medical Information. Parent/Guardian s name: Work Phone: Home Phone: Cell Phone:
CULINARY CAMP Contact and Medical Information Child s name: Parent/Guardian s name: Work Phone: Home Phone: Cell Phone: Email: In case of an emergency, when neither parent/guardian can be reached, please
More informationGovernors State University, College of Arts and Sciences Summer 2018 STEAM Camp Registration
Governors State University, College of Arts and Sciences Summer 2018 STEAM Camp Registration This is the registration form for the 2018 STEAM Camps at Governors State University. You may register by filling
More informationSavannah Police Department 2018 PAL Youth Summer Camp Boys: June 18th 22 nd, July 9th 13 th Girls: June 25th 29th, July 16th 20th Application Form
Savannah Police Department 2018 PAL Youth Summer Camp Boys: June 18th 22 nd, July 9th 13 th Girls: June 25th 29th, July 16th 20th Application Form The Savannah Police Department will be sponsoring a summer
More informationMEDICAL INFORMATION AND MEDICAL TREATMENT RELEASE AND AUTHORIZATION FORM
MEDICAL INFORMATION AND MEDICAL TREATMENT RELEASE AND AUTHORIZATION FORM Camp Information Address: City, State, Zip Code: Gender: Medical Information The decision whether to permit the participant identified
More informationSummer Camp Application INTERNATIONAL DEVELOPMENT 101
INTERNATIONAL DEVELOPMENT 101 Student Information Student Name: Sex : Male / Female Student Preferred/Nickname: Mailing Address: Home Phone Number: Cell Phone Number: School: Grade (Entering): Date of
More informationInformation about membership -
MEMBERSHIP INFORMATION 2018 We are excited about ST. CROIX JOAD and the opportunities that will present themselves to youth archers ages 8-20. ST. CROIX JOAD is one of only a handful USA ARCHERY JOAD clubs
More informationSchedule: When: Saturday, December Time: 9:00-4:00pm Where: Garrett s Sports Complex/Fieldhouse Cost: $60/ per athlete
When: Saturday, December 9. 2017 Time: 9:00-4:00pm Where: Garrett s Sports Complex/Fieldhouse Cost: $60/ per athlete Instructors: SU Coaches & current SU Athletes Schedule: 9:00-9:45 Registration 9:45
More informationPre Health Professions Conference Saturday, March 4, Registration Form Spots are limited and on a first come first serve basis
Office of Diversity and Inclusion Pre Health Professions Conference Saturday, March 4, 2017 Registration Form Spots are limited and on a first come first serve basis Please Note: Registration is not complete
More information2018 CENTRAL WASHINGTON UNIVERSITY MEN S RUGBY ELITE PROSPECT CAMP
2018 CENTRAL WASHINGTON UNIVERSITY MEN S RUGBY ELITE PROSPECT CAMP SAT., MAY 26 8 a.m. 4 p.m. Todd Thornley CONTACT PHONE: 509-963-2312 E-MAIL: todd.thornley@cwu.edu REGISTRATION DUE FRIDAY, MAY 18, 2018
More informationD.M.G. Athletics. The Official Indoor/Outdoor Summer Basketball League. Team Registration Packet
D.M.G. Athletics Presents The Official Indoor/Outdoor Summer Basketball League Team Registration Packet Questions: Contact Coach Dawne Gittens at 860-929-7692 or via email at dgittens@bgchartford.org Team
More informationSUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM
SUMMER CAMP ACKNOWLEDGEMENT OF RISK FORM I,, am the parent and/or legal guardian of, a minor child under the age of 18 years. I would like to have my child participate in the following CAMP/PROGRAM at
More informationCape Cod Community College Summer of Science Program REGISTRATION APPLICATION Page 1 of 6
REGISTRATION APPLICATION Page 1 of 6 INSTRUCTIONS Complete ALL Registration Application Pages (1 6), please make checks payable to:. Mail to: The Center for Corporate and Professional Education, Hyannis
More informationST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS
ST. CLOUD AREA FAMILY YMCA SUMMER CAMP WAIVERS Parent Statement of Understanding The following information is important for the safety and protection of your child. Please read this information and sign
More informationFirst Name: Middle Initial: Last Name: Gender: D.O.B: / / Age: Years of YMCA Camp Participation: Address: Apt/Unit #:
Camp Location: Camper Grade 2017-18 School Year: Does your camper require any special needs identified through Section 504 (I.D.E.A or an I.E.P)? Yes No If yes, please explain: Camper Grade 2018-19 School
More informationSustainable Agriculture Internship Application
P.O. Box 437462 Kamuela, Hawai i 96743 +1 808 887-6411 Fax +1 808 885-6707 kohalacenter.org 2015 2016 Sustainable Agriculture Internship Application Please complete the application information below and
More informationCHINESE CULTURE CAMP REGISTRATION FORM
CHINESE CULTURE CAMP REGISTRATION FORM Child s Information: Last Name: First Name: MI: Nickname: Gender: M F Birth Date: Age: Primary Phone #: School Attending: Grade: Parent(s)/Guardian(s) Information:
More information5-STAR ACADEMY OF PERFORMING ARTS Student Registration Packet- WINTER 2019
5-STAR ACADEMY OF PERFORMING ARTS Student Registration Packet- WINTER 2019 STUDENT NAME: BIRTH DATE: GENDER: _ ADDRESS: PARENT NAME: PARENT EMAIL: PARENT PHONE NUMBER: PARENT WORK NUMBER: SECONDARY CONTACT
More informationWaiver, Release of Liability, Assumption of Risk, Indemnification, and Participation Agreement
Name: Waiver, Release of Liability, Assumption of Risk, Indemnification, and Participation Agreement I, the undersigned individual, desire to use the U ROCK ( U ROCK s.a.l.) facilities located at Rebound
More information2018 Summer Science Program Registration & Release The University of Texas Marine Science Institute Mission Aransas National Estuarine Research
2018 Summer Science Program Registration & Release The University of Texas Marine Science Institute Mission Aransas National Estuarine Research If registering multiple children, fill out one form per child
More informationCITY KIDS DAY CAMP REGISTRATION FORM
RETURN CAMP ENTRY FORM WITH PAYMENT TO: M.C. PARKS 100 E. MICHIGAN BLVD. SUITE 2 MICHIGAN CITY, IN 46360 (219) 873-1506 www.michigancityparks.com CITY KIDS DAY CAMP REGISTRATION FORM 1. HOUSEHOLD INFORMATION
More informationPARTICIPANT AGREEMENT (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
EXHIBIT D PLEASE READ CAREFULLY (For Adult Participants) RELEASE OF LIABILITY, VOLUNTARY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I,, a person being over the age of eighteen, hereby enter this RELEASE
More informationRelease of Liability PLEASE DO NOT CHANGE OR ALTER THE WORDING ON THIS WAIVER WITHOUT PRIOR APPROVAL FROM USROWING.
Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy
More informationWEB: eaglelakecamps.com. PHONE: 800-US-EAGLE ( ) (local) FAX:
WEB: eaglelakecamps.com PHONE: 800-US-EAGLE (873-2453) 719-272-7453 (local) FAX: 719-960-2558 MAIL: Eagle Lake Office P.O. Box 6819 Colorado Springs, CO 80934 RELEASE OF LIABILITY AND CONSENT TO MEDICAL
More informationCITY OF PALM COAST YOUTH PARKS & RECREATION DEPARTMENT ADULT REGISTRATION FORM SENIOR
CITY OF PALM COAST YOUTH PARKS & RECREATION DEPARTMENT ADULT REGISTRATION FORM SENIOR Please print clearly. Completion of the registration process is required for each participant prior to program start
More informationChild: L M S XS. Session I - June Overnight Camper (9-18 years) or Day Camper (7-18 years)
THIS APPLICATION IS FOR MANUAL REGISTRATIONS ONLY Print and mail with $100 Non Refundable deposit or full amount to: Box 870393 Tuscaloosa, AL 35487 Full Name: Preferred Name: Address: City: State: Zip:
More informationSALES KICKOFF SUMMIT February 23 & 24, AM PST. Powered by:
SALES KICKOFF SUMMIT February 23 & 24, 2016 9AM PST Powered by: 30+ Sales Tech Experts. 7,000+ registrants within sales and marketing teams 7,000+ Targeted Registrants PRIMARY TARGET: C-Level Execs, Sales
More informationSession I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church
th Session I and Session II Session I: June 5 June 9, Performance June 10th; Hollydale United Methodist Church Session II: June 12th - June 16th, Performance June 13th; Music On Wheels Academy Music Camp
More informationRelease and Waiver of Liability. Release and Waiver of Liability for Adults Page 2 & 3. Release and Waiver of Liability for Minor Page 4 & 5
Release and Waiver of Liability Release and Waiver of Liability for Adults Page 2 & 3 Release and Waiver of Liability for Minor Page 4 & 5 1 Release and Waiver of Liability for Adults Adult - An adult
More informationRELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS
RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS Activity: CSU, Chico Recreational Sports Youth Camps Activity Date(s) and Time(s): Summer 2018 (June 11 August 10,
More informationCAMP ENROLLMENT FORM
CAMP ENROLLMENT FORM *This camp program is a tuition for service program, based on confirmed enrollments and secured deposits. A $35 per camper, per session non-refundable and non-transferable deposit
More informationDear Team Captains, Managers and Members The waiver consists of : 1. Team Waiver which also acts as the team roster. 2. Combined Team waiver signature page for: Apendix A, B, B1, C 3. Appendix A: Team:
More informationDeerfield Beach Surf Camp 2018 Registration Form
Deerfield Beach Surf Camp 2018 Registration Form For camp information call 954-281-2797 or go to www.islandcamps.com Camper s name DOB Parent/Guardian Name Address City State Zip Email: Phone (C) Phone
More informationRegistration Form. Mother s/guardian Name: LAST FIRST INITIAL Address: Home Phone: City: State: Zip: Cell Phone:
Registration Form Name: Address: City: State: Zip: School: Grade: Grad Year: GPA: HT: WT: Cell Phone: Email: Size: Shirt: Pants: Helmet: Shoe: Jersey #: (List 3 numbers) Parent/Guardian Information Player
More informationSt. Thomas of Villanova Scholars (STOVS) Summer Program July 5-22, 2017
St. Thomas of Villanova Scholars (STOVS) Summer Program July 5-22, 2017 Personal Information Full Name: Address: Last First M.I. Street Address Apartment/Unit # City State ZIP Code Home Phone: ( ) Alternate
More information2019 Indoor Baseball Clinic Boys Ages 7-10
Department of Parks & Recreation - Recreation Division 101 Field Point Road, Greenwich, CT 06836-2540 Phone: (203) 618-7649 Email: Recreation@greenwichct.org 2019 Indoor Baseball Clinic Boys Ages 7-10
More informationBlue Knob Snow Sports Club, Inc Registration Form 2018/2019 Ski Season
Registration Information: 1. All participants should be at least 8 years of age (Category U10) by Dec 31 st 2018. 2. Intermediate skiing skills are necessary (parallel turns on most slopes). 3. Participants
More informationSUMMER YOUTH PROGRAMS 2018 PARTICIPATION INFORMATION FORM
SUMMER YOUTH PROGRAMS 2018 PARTICIPATION INFORMATION FORM Personal Information Child s Name Age of Birth Parent/Legal Guardian 1 Phone Parent/Legal Guardian 2 Phone Address Alternate Phone work cell other
More informationOHIO CAMPus REC Summer Camp
OHIO CAMPus REC Summer Camp AGREEMENT AND RELEASE OF LIABILITY FORM This release executed by the Undersigned on behalf of [Name of Participant] with an address at ( Participant ) to Ohio University, Athens,
More informationASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT
ASSANTE DIRTY DASH FOR REBOUND - 5K MUD RUN RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT Participant s Name: Age: Date of Birth : (M) (D) (Y) Address: City: Province:
More informationAuburn University Montgomery
Auburn University Montgomery Coach Newell s AUM Softball Prospect Camp Coach Newell will be hosting softball prospect camps on multiple dates throughout the fall of 2017. These camps will be limited to
More informationMedical Release Form/Media Release Form
Medical Release Form/Media Release Form All participants in TCS events must have a signed Waiver & Release Form, including adults 19 years and older. Participants under 19 must have the authorized signature
More informationRELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS
RELEASE OF LIABILITY, PROMISE NOT TO SUE, ASSUMPTION OF RISK AND AGREEMENT TO PAY CLAIMS Name : Date of Birth: Camp: Camp Date(s) and Time(s) In consideration for the privilege to attend the Oakland University
More informationStark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver
Stark Museum of Art Application for Summer 2018 Art Quest Program, Health Form/Consent, and Liability Waiver Camp Sessions Listed on Page 2 Application Due June 22, 2018 Application must be complete in
More informationDAY CAMP ENROLLMENT FORM
2018-2019 DAY CAMP ENROLLMENT FORM *This camp program is a tuition for service program, based on confirmed enrollments and secured deposits. A $35 per camper, per session non-refundable and non-transferable
More informationMCC Summer Camp Application
MCC Summer Camp Application Summer Camp Enrollment Guidelines Applicants are considered on a first-come, first-serve basis. Only complete application packets are considered. A complete application packet
More information2016 Registration Packet Jedi Master Engineering using Legos Summer Camp
2016 Registration Packet Jedi Master Engineering using Legos Summer Camp Mailing Instructions Please e-mail your completed and signed REGISTRATION, PERMISSION WAVIER, CODE OF CONDUCT, and PHOTO RELEASE
More informationVILLANOVA UNIVERSITY ENTERTAINER AGREEMENT
VILLANOVA UNIVERSITY ENTERTAINER AGREEMENT This Entertainer Agreement (the Agreement ) dated is by and between ( Entertainer ) and Villanova University ( Villanova ). For good and valuable consideration,
More informationLake Washington Rowing Club
Lake Washington Rowing Club 2018 Junior Rowing Program Participant Information Form Participant Information (all fields must be filled out),, Last Name First Name Today s Date Mailing Address Birthdate
More informationMAKE WELLSTON BEAUTIFUL, INC
MAKE WELLSTON BEAUTIFUL, INC Parks and Recreation Programs REGISTRATION FORM Please submit this form along with your completed Emergency/Release Form and Registration Fee. Make checks payable to Make Wellston
More informationI. Appendix B - Summer Camp Release and NCAA Compliance Attestation
I. Appendix B - Summer Camp Release and NCAA Compliance Attestation For Participation in Activity in University Department of Athletics Facilities For the purposes of this document, herein after referred
More informationSHOOTING STARS FILM CAMP Hay Street Fayetteville, NC
SHOOTING STARS FILM CAMP 2019 121 Hay Street Fayetteville, NC 28301 910.486.9036 Application 2019 Week 1 June 17-21 : COST: $250 Week 2 June 24-28 : TIME: 11:00a to 5:00p Drop-off 10:45a to 11:00a Pick-up
More informationThe Competition starts at 00:00 on Monday, 4 June 2018 and ends at 23:59 on Thursday, 19 July 2018 ( Competition Period ).
THE STANDARD BANK OF SOUTH AFRICA LIMITED ( STANDARD BANK/WE/US/OUR ): TERMS AND CONDITIONS IN RESPECT OF THE STANDARD BANK MY FEARLESS NEXT COMPETITION ( COMPETITION ) Important clauses which may limit
More informationAFCC CAMPER REGISTRATION FORM
AFCC CAMPER REGISTRATION FORM Camper s Name Gender: M F Phone Number Email Address Address City/State/Zip Sponsor or Student Grade Completed (if student): Age Birthdate Church City T-Shirt Size: YM YL
More informationCorynna s Wish. Application for Corynna s Wish. Here Are the Requests We Are Unable to Grant. Eligibility Requirements for Recipients
Corynna s Wish Corynna s Wish is a nonprofit granting entity that is dedicated to fulfilling wishes that patients and their families cannot accomplish either physically or financially. The organization
More information2017 Haunted Halloween Race
2017 Haunted Halloween Race October 28, 2017 5:30pm 7:00pm (1.5 hour meet at regular speed session time) Hosted by: Core Speedskaters INFORMATION You must be a member of Northern California Speedskating
More informationRegistration Form Spots are limited and on a first come first serve basis
Office of Diversity and Inclusion McGovern Medical School s JAMP Symposium April 15 th or April 20 th, 2016 Registration Form Spots are limited and on a first come first serve basis Please Note: Registration
More informationHorse s Name Reg. No. DOB MM/DD/YY Sex Color Sweepstakes Yes No Sire Dam Horse USEF ID# Horse USDF #
C R Rider 1 Elmira Arabian & Sport Horse Classic Horse Show May 25 th -27 th, 2018 USEF Entry Form Entries Close May 10 th, 2017 PLEASE TYPE OR PRINT ONLY ONE HORSE PER ENTRY FORM. Horse s Name Reg. No.
More informationWAIVER 2019 DEL MAR JUNIOR LIFEGUARD / LITTLE TURTLE / XTENDED PROGRAM
WAIVER 2019 DEL MAR JUNIOR LIFEGUARD / LITTLE TURTLE / XTENDED PROGRAM NOTE There are 5 pages of waiver forms, 4 need signatures, check the back of print outs! DUE DATE On or before June 1 st, 2019 INSTRUCTIONS
More informationALBION COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS
ALBION COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I, (or hereinafter on behalf of my minor child) ( Participant ), hereby acknowledge
More informationDate of Birth Address City State Zip
RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. You have the right to consult
More informationJAGUARS ACADEMY TERMS AND CONDITIONS
1. Introduction JAGUARS ACADEMY TERMS AND CONDITIONS 1.1 This document is intended to, and does, set out the Terms and Conditions which apply to: (i) the Jacksonville Jaguars Jaguars Academy event, consisting
More informationSponsorship Agreement
Sponsorship Agreement Town of North Collins Anthony Rotella 10569 Main Street 3/16/2018 North Collins, New York 14111 716-531-6185 Dear Anthony Rotella, Thank you for taking the time to discuss the opportunity
More information2018 REGISTRATION FORM - COMPLETED FORM WITH PAYMENT MUST BE RECEIVED BY THE CONTINUING EDUCATION DEPT. FOR STUDENT TO BE REGISTERED FOR CAMP.
Summer Camps 2018 Luzerne County Community College 1333 South Prospect Street, Nanticoke, PA 18634 Tel: 570-740-0495 Fax: 570-740-0491 www.luzerne.edu/coned 2018 REGISTRATION FORM - COMPLETED FORM WITH
More informationPLEASE READ THESE TERMS AND CONDITIONS CAREFULLY BEFORE PARTICIPATING IN THE EVENT/ USING ANY EVENT PLATFORM.
TERMS AND CONDITIONS FOR THE NIKE BATTLE FORCE EVENT NIKE Philipinnes Inc. ( Nike ) in media partnership with Creative Programs, Inc. ( CPI ) is sponsoring a competition-based event designed to support
More informationUGA Livestock Judging Camp Athens, Georgia June 26-28, Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School:
PLEASE PRINT UGA Livestock Judging Camp Athens, Georgia June 26-28, 2018 Participant Name: Parent/Guardian: Phone: Address: City: State: Zip: School: Email: Grade: Shirt Size: YS YM YL YXL AS AM AL AXL
More information** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club
** Important Notice to Summer Camp Program Parents ** Kiddie, Day, and Youth In Action ** Leaders Club As a new year of Kent County Parks and Recreation Summer Camp fun is quickly approaching, we want
More informationCOLLEGE OF CHARLESTON LIABILITY RELEASE, EMERGENCY MEDICAL AUTHORIZATION AND AGREEMENT (Domestic Travel)
COLLEGE OF CHARLESTON LIABILITY RELEASE, EMERGENCY MEDICAL AUTHORIZATION AND AGREEMENT (Domestic Travel) 1. I, the undersigned student desire to participate in the following activity/trip ( Activity ),
More informationB.A.M. Brevard Attitude Modification
PLEASE PRINT Minor s Name: Age: Grade Entering: Date of Birth: Gender: (Male or Female) Address: City: Zip: Home Phone: Parent/Guardian Name: Place of Employment: Work Phone: Driver s License Number: Cell
More informationPlease fill out both sides of this form!!!
$ # Circle one: Mixed Doubles Rockbridge Hunt Hunter Pace & Trail Ride Please fill out both sides of this form!!! Entry fee: Adult rider (18 and over) -- $35 per horse Junior rider (under 18) -- $20 per
More informationRegistration Form. Special Information (allergies, medical, behavioral, etc) you would like us to know about the gymnast/dancer:
Registration Form Gymnast/Dancer Information Name: Date of Birth (MM/DD/YYYY): School (For Scheduling Purposes): School District (For Scheduling Purposes): Special Information (allergies, medical, behavioral,
More informationSKATEBOARD COMPETITION ENTRY FORM
CITY OF KISSIMMEE PARKS, RECREATION & PUBLIC FACILITIES SKATEBOARD COMPETITION ENTRY FORM For your convenience, competition entry forms will be accepted in person, by mail, via fax or email at the location
More informationStark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver
Stark Museum of Art Application for Summer 2016 Art Quest Program, Health Form/Consent, and Liability Waiver Camp Sessions and Costs Listed on Page 2 Application Due June 9, 2016 Application must be complete
More information2018 Oakland Soccer Camp Application BOYS CAMP ONLY
2018 Oakland Soccer Camp Application BOYS CAMP ONLY Name: Address: City: State: Zip: Home Phone: Work Phone: Email (Required): Age: Grade: (At time of camp) (Fall 2018) All confirmations will be sent via
More informationDance Competition Rules and Regulations
Dance Competition 2017-2018 Rules and Regulations Hmong Cultural New Year Celebration, Inc. Competition 2017-2018 will be held on December 27 through December 29. HCNYC Policy: all contestants pay the
More informationSHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver
SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2018 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 22, 2018 Application
More information(Student Last name, First name Middle Initial).
2013-14 (Student Last name, First name Middle Initial). Consent for Field Trip (P1a) DHS Band Combined Form P1a, P1b, P1c I hereby consent for the above named student to participate in athletic team, band,
More informationIndividual Football Camp
Offensive/Defensive REGISTER AND PAY ONLINE AT WWW.BEARCATFOOTBALLCAMPS.COM REGISTRATION: 2019 Seniors 8 a.m. Underclassmen 9 a.m. Camp begins at 10 a.m. All Northwest coaches will be working the camp.
More informationAthletics Participation and Pre-Participation Head Injury/Concussion Reporting Form
Athletics Participation and Pre-Participation Head Injury/Concussion Reporting Form Fall Athletics, 2018 The Parent(s)/Guardian(s) must fill in all blanks. Please print clearly. Athlete s Name: Date of
More informationAfter School Program Registration Form
To enroll your child in the Duncanville Fieldhouse AFSP Program, please complete the information below and return to the Fieldhouse Front desk along with payment and a completed registration packet. CHILD
More informationSHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver
SHANGRI LA BOTANICAL GARDENS AND NATURE CENTER 2019 EcoRangers Application, Health Form/Consent, and Liability Waiver CAMP SESSIONS AND COSTS LISTED ON PAGE 2 APPLICATION DUE DATE: JUNE 21, 2019 Application
More informationPLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!
HABITAT FOR HUMANITY OF KNOX COUNTY, OHIO, INC. 200 North Main Street Mt. Vernon, OH 43050 Office (740) 393-1434 Fax (749) 393-1157 Release and Waiver of Liability for Minors It is the policy of Habitat
More informationA n A d v e n t u r e & E x p l o r a t i o n D e s t i n a t i o n f o r K i d s
Dear C.I.T. Applicant: Thank you for your interest in joining Wheel Kids Coach-In-Training program. It s a great opportunity to learn new skills, build on skills you already have, and have fun in a new
More informationTween and Teen Think It, Move It for Students with Social Challenges
Tween and Teen Think It, Move It for Students with Social Challenges This unique program will combine the introduction of social thinking concepts with motor development. Our tweens and teens will receive
More information2019 Nashville Pilot Camp Registration
2019 Nashville Pilot Camp Registration Camp Information The following pages contain the registration form, code of conduct, and all medical paperwork to be filled out. Be sure to fill these out and mail,
More informationYMCA of the Coastal Bend Summer Camp 2018 Enrollment Form
PARTICIPANT INFORMATION: YMCA of the Coastal Bend Summer Camp 2018 Enrollment Form Child (1) Name: Sex: [M] [F] (circle one) of birth: / / Camp Type/Location: YMCA Day Camp (Pre-K - 5 th ) Downtown YMCA
More informationEMERGENCY CONTACT INFORMATION. Name of person to contact in the event of an emergency;
BATTLE CREEK AREA HABITAT FOR HUMANITY WOMEN BUILD MAY 5, 9-12, 2018 (Battle Creek) MAY 17-19, 2018 (Marshall) VOLUNTEER APPLICATION (Please return via email, fax or mail) Name: (please print) Maiden Name:
More informationYouth Camp REGISTRATION
Youth Camp REGISTRATION Parent #1 Name Home Phone Work Phone E-mail Address City State / ZIP Parent #2 Name Home Phone Work Phone E-mail Address City State / Zip 1. Camper s Name Age Gender Green and Gold
More informationTown of Dover Recreation Department Day Camp Registration Form
Town of Dover Recreation Department Day Camp Registration Form Name of Camper: Address Age Grade Entering in fall Male/Female Phone # Cell # Date of Birth (Please circle all that apply) Full Day 1. Session
More informationSouth Suburban Youth Rugby Club
South Suburban Youth Rugby Club Middle School Grades 4-8 High School Fresh-Soph & Varsity Registration for 2016 Spring Season ALL FORMS MUST BE COMPLETED AND TURNED IN AND DUES PAID IN FULL BEFORE A PLAYER
More informationMOTIVATE ME Young Men s Conference 2014
Greetings! Thank you for your interest in the Illinois Association for College Admission Counseling s MOTIVATE ME Young Men s Conference! Whether you applied online or sent us a paper application, these
More informationCamp Tatanka Summer Camp Registration Form
WTAMU and the City of Canyon Child s First Name Camp Tatanka Summer Camp Registration Form Camper & Parent s Information Last Name Grade Fall 2018: Age (on 1 st day of camp): Birth Date: / / M / F Child
More informationMembership and Facility Rules
Membership and Facility Rules 1. Membership is for the period of 1-1-18 thru 12-1-18, which includes: Access to the tracks when the tracks are open o In the event you would want to ride on a day the track
More informationHELPING PEOPLE KNOW CHRIST THROUGH HIS WORD Name of Church: City/State:
Please note, the second page of this document must be signed and notarized. FOR OFFICE USE ONLY Code: Team: AQU BLU ORG YLW GRN HELPING PEOPLE KNOW CHRIST THROUGH HIS WORD WWW.STUDENTLIFE.COM Waiver &
More informationTexas Southern University Ocean Of Soul Marching Band. Summer Band, Auxiliaries, and Drum Major Camp Sunday, June 18 th to Saturday, June 24 th, 2017
Texas Southern University Ocean Of Soul Marching Band Summer Band, Auxiliaries, and Drum Major Camp Sunday, June 18 th to Saturday, June 24 th, 2017 Ocean of Soul Band Camp Registration Information All
More information