SU Softball Summer Camp

2022 LADY BISON PROSPECT CAMP

MAY 26, 2022

7TH GRADE AND UP

Southern Union Softball, Head Coach Ally Silva, and assistants, Katlyn Jaye and Cooper Childers, invite you to come receive next level instruction to kick off your summer. Receive instruction on hitting, fielding, and pitching. The Southern Union Prospect Camp is also a great opportunity to get noticed by the coaching staff.

Don't miss your opportunity to become a Lady Bison!! The camp will be held at the Southern Union Softball Stadium in Wadley, Alabama.

$60 PER CAMPER

All checks should be made payable to Southern Union State Community College.

***PAYMENTS CAN BE PAID UPON ARRIVAL ON MAY 26***

Southern Union Softball Stadium:

750 Roberts Street

Wadley, Alabama 36276

Camp Itinerary:

8:20AM-8:50AM: CHECK IN

9AM-12PM: HITTING AND DEFENSE

12PM-1PM: LUNCH [CAMPERS ARE RESPONSIBLE FOR THEIR OWN LUNCH]

1PM-4PM: SCRIMMAGE

Athlete Information

Athlete's Name *

First Name Last Name

High School Name *

Graduation Year *

(7th grade and up)

High School Coach Name *

First Name Last Name

High School Coach Phone Number *

Please enter a valid phone number.

High School Coach Email Address *

Emergency Information

Emergency Contact's Name *

First Name Last Name

Relationship *

Phone Number *

Alt. Phone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe. *

Is the athlete prescribed an inhaler? If yes, please explain any instructions. *

Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Southern Union Softball during the selected camp. In exchange for the acceptance of said child’s candidacy by Southern Union, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Southern Union, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Southern Union, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to Southern Union and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature *

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Southern Union Lady Bison