Tracy Mason Women's Basketball Camp

Medical/Insurance Release Form

 

Medical Waiver Form:

In order for all participants to participate in the camp, everyone must have this form completed by the first day of camp.

 

Release And Medical Authorization:

In order for all participants to participate in camp activities, his/her parent or guardian must sign this release and medical authorization form.

COVID-19:

Tracy Mason Women's Basketball Camp cannot prevent the participant or the participant's family from becoming exposed to, contracting, or spreading COVID-19 while utilizing the facilities and/or equipment at Southern Utah University. If your child is sick or showing any signs of COVID-19 please be diligent regarding staying at home. This is for the health and safety of everyone.

 

Release From Liability:

In consideration of the Tracy Mason Women's Basketball LLC, hereafter referred to as Tracy Mason Women's Basketball Camp, granting the participant permission to participate in the camp, I hereby assume all risks of his/her personal injury that may result from camp activity. As parent/guardian, I do hereby release Tracy Mason Women's Basketball LLC, and their officers, employees, agents, instructors, and athletes in said Camp program from liability, including claims and suits at law or inequity, for injury which may result from the student taking part in camp activities.

I acknowledge that the activities associated with Tracy Mason Women's Basketball LLC are not sponsored, supervised or otherwise controlled in any way by the University; all activities of Tracy Mason Women's Basketball LLC are independent of the University, regardless of whether University employees are present at the particular facility. As such, I acknowledge that Tracy Mason Women's Basketball LLC and myself are solely responsible for any risk management including without limitation proper first aid and other intervention that may be needed.

Medical Authorization:

I request and authorize the proper personnel of this camp to refer to an appropriate medical facility, for treatment of illness, injury or both; and I further authorize the physician(s) selected by the camp personnel to eat said injury or illness as they think best for the most advantageous welfare of the participant if that should be a circumstance.

Assumption Of Risk:

I (the term "I" in this release refers both to the participant, and his/her parents or legal guardians) recognize that basketball is a sport that involves jumping, landing, turning, and stopping, therefore there are risks involved. I am fully aware of and appreciate the risks including the risk of catastrophic injury. This may be caused by the participants own actions or inactions or by those of others participating in the activity. I knowingly, voluntarily and willingly assume all risks, loss, damage or injury and give my consent for my child(ren) to participate.

Health Insurance:

I understand that health insurance is a requirement to participate in any activities of Tracy Mason Women's Basketball Camps. I certify that I have health insurance or am personally responsible to cover any injury for my child(ren) and guarantee payment of any medical expenses incurred as a result of participating in our camp.

In Case Of Emergency, Please Contact: