Mega Sports Camp

Child's Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

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Children entering Young Fives or Kindergarten and those who have completed Kindergarten will be enrolled in our SPORTS BASICS CLINIC.

Sports Basic Clinic

Those who have completed 1ST—5TH GRADES: Select the activity below that you would like to participate in for the week. Choose only one.

Basketball

Flag Football

Soccer

Science Lab

Sewing

Home Phone

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Cell Phone *

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Waiver & Release of Liability *

1. I, the parent/guardian, have considered and evaluated the risks, danger and possibility of injury to my child resulting from participation in Mega Sports Camp. 2. I understand reasonable safety precautions will be taken by Evangelical Covenant Church of Whitehall (ECC), the church’s employees or volunteers and/or any other person involved in Mega Sports Camp. I understand the possibility of unforeseen hazard/injury from foreseeable and unforeseeable sources that could occur to my child. 3. I knowingly assume all costs, risks of injury and/or other damages resulting from my child’s participation in Mega Sports Camp. 4. In the event of an injury to my child during Mega Sports Camp, I give permission to ECC staff or volunteers to arrange for all necessary medical treatment for which I shall be financially responsible. I give ECC power to seek appropriate medical treatment or attention on behalf of my child as may be required by the circumstances. I further understand that every effort will be made to contact me or those listed as emergency contact persons in the event of an emergency. 5. I, the undersigned, hereby consent to the use of any videotapes, photographs, slides, audiotapes, or any other visual or audio reproduction, including internet use in which my child may appear by ECC and approved staff and volunteer workers taken during an outing/ event approved by ECC. I understand that these materials are being used for promotion of the ministry of ECC.

I have read, understand and agree with this waiver

Privacy Preference

Please do not use my child’s image in any promotional materials.