Text Box: MEDICAL RELEASE AND PARTICIPATION WAIVER Text Box: I (we), the undersigned parent(s)/guardian(s) of said participant, fully understand that there are risks involved in my (our) child’s participation in the said camp.  I (we) represent that (my) our child voluntarily desires to participate in activity; and that I (we) am (are) duly aware of the risks and hazards that may arise through participation in activity.  In consideration for my (our) child’s participation in said camp, the undersigned hereby voluntarily assumes all risks of accident or damage to person or property and risks of liability.  The undersigned does further agree to indemnify and hold harmless Belle Volleyball Camps and Central High School and its regents, administrators, employees or agents from any and all claims or demands for loss, cost, injury , or damage whatsoever arising from negligence, especially from injury resulting from my (our) child's improper use of equipment, technique, or failure to follow safety rules and instructions.  The undersigned, by signing this release, hereby certifies that the undersigned has read and fully understands the conditions herein provided and that he/she signs this agreement voluntarily and without reliance upon any promise or representation which is not contained in this agreement.   We (I) give authorization to the athletic training staff or designated entity to evaluate our (my) child and treat any injuries that occur during said activity.  This includes immediate first and treatment, referral to hospital or physician consultation, and/or emergency services.  We (I) hereby grant the athletic training staff or designated entity to secure medical services that are in the best interest of our (my) child.   Date:___________________   Camper’s Name:_______________________________________________________   Printed Parents Name:___________________________________________________   Parent’s Signature:  _____________________________________________________   A $15 Participation Fee should accompany each player on the roster.      2012 Team Competition Camp

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                                                               

 

                                                                       

 

 

Back to Home