Jim Morris Baseball Camps Camp Waiver printable pdf download

Jim Morris Baseball Camps Camp Waiver

*Please bring this form to camp for check in, will not be allowed at camp without this

being filled out and brought to camp.

RELEASE FOR MEDICAL TREATMENT

Application WILL NOT be complete until this form is completed, signed and returned before camp starts or at check in.

Since most of the students attending camp are under 18 years of age, it is necessary that our doctors have the permission

to administer treatment in the event of an accident or sudden illness. If you are 18 years of age or older, sign your name.

Name: ____________________________________ Date: ______________

List any conditions that physicians should be aware of:

___________________________________________________________________

Phone number for emergencies:

DAY ____________________________ NIGHT:_________________________________

I hereby authorize any medical treatment which may be advised or recommended by the attending physician or

(camper’s name) while at Jim Morris Baseball Camp.

PARENT/GUARDIAN SIGNATURE: ______________________________________

INSURANCE COVERAGE

Insurance Coverage for accidental injury is required by all participants. If at the time of injury, no family insurance

exists, limited secondary coverage would be available at a per session cost of $25.00 purchased prior to camp

commencement. Coverage is subject to policy terms, conditions, limitations and exclusions. Please indicate your current

insurance below or if secondary camp coverage is necessary.

*Please pick one

Option #1

I HAVE THE REQUIRED INSURANCE ___ *Please put yes or no.

Insurance Company and Policy Number:

___________________________________________________________________

Option #2

I WISH TO PURCHASE ACCIDENT INSURANCE AT $25.00

IF YOU ARE 18 YEARS OF AGE OR OLDER SIGN YOUR NAME.

___________________________________________________________________

RELEASE AND WAIV E R OF L IAB I L I T Y

(PLEASE READ CAREFULLY BEFORE SIGNING)

The undersigned hereby acknowledges that participation in the camp and related activities involves

an inherent risk of physical injury, and the undersigned, on behalf of the registrant, hereby assumes

all such risk and does hereby release and forever discharge the camp and all employees and agents

thereof from any and all known liability of whatever kind of nature, arising from and by reason of

any and all known and unknown, foreseen and unforeseen body and personal injuries, damage to

property, and the consequences thereof, resulting from the registrant’s participation in or

involvement with this camp, including any failure of equipment or defect in the premises. Any

photographs taken at the camp are subject to be used in the brochure in future years and can possibly

be used for advertising the camp. I hereby state that I am the legal guardian of said child.

DATE: _____________ SIGNATURE OF PARTICIPANT: ____________________________________________

SIGNATURE OF PARENT OF GUARDIAN: _______________________________________________________

Jim Morris Baseball Camps Camp Waiver