[name of Sports Camp], I could possibly sustain As a potential participant of the injuries no matter how well conditioned I may be. Depending on the nature of the sport, injuries may be minor to fatal in nature. Some specific injuries that may be sustained by participants in physical activity associated with sports such as this one are as follows: stoppage of breathing, spine and neck injuries (either of which could result in paralysis), concussion, heart failure, broken legs, feet, ankles, toes or other bones, heat stroke, heat cramp, heat exhaustion, stroke, convulsion, unconsciousness, abrasions to limbs such as arms, legs and head, fainting, sudden illness, cramps, and loss of wind. This list is not conclusive.
Physical contact poses risks in[name of Sports Camp] activities as well, even though it occurs regularly as an accepted part of the sport. The propensity for major injuries, such as injuries to the spinal column, broken bones, concussion and internal injuries to major organs increases in relation to the force of impact upon contact or collision. I understand the risk of injury due to the force of a collision. I realize that if I have physical problems such as a heart condition, hypertension, orthopedic problems, or other medical problems, I should consult a physician concerning any limits to my activity.
Iagree to comply with all camp rules and regulations, including those given verbally and in writing. I also agree to participate in
safety meetings and the presentation of any safety material.
Knowing the inherent risks, dangers, and rigors involved in the activities in which I choose to participate at this camp, I certify that I am fully capable of participating in the activities offered.
I hereby give permission for the certified athletic trainer, physicians, and/or other health care providers to issue medical careas
deemed necessary in the event that my child sustains an injury or illness while attending camp including transportation and hospitalization, if necessary.
I certify that the information provided is true and complete to the best of my knowledge. I understand that misrepresentations, omissions of facts, or incomplete information regarding my child's medical history could jeopardize his/her health and physical well-being and interfere with the camp medical staff's ability to provide proper medical care.
It is further understood that Southern University & A&M College does not provide medical insurance covering injuries of any nature sustained at Southern University & A&M College camps or clinics. The undersigned hereby release, indemnify, and hold harmless Southern University & A&M College, its successors, agents, trustees, assignees, officers, employees, and representatives, Including the Department of Athletics, the coaching and athletic training staff, and camp employees from any and all claims, demands, and causes of action whatsoever in any way resulting from participation in the Southern University camp or clinic, including overnight stays on campus, if applicable.
Icertify that I have read this ACKNOWLEDGEMENT OF RISK Form and understand all of its terms.