CAMP81 Skills Training Registration Form
Form must be completed for each child even if in same family.
Player Details:
Full Name
*
First Name
Last Name
Date of Birth: Ok to Celebrate?
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent's Phone Number
*
Child's Phone Number
Parent's E-mail
*
example@example.com
How did you hear about us?
Please Select
Cy-Fair Ravens
CAMP81 Player
Internet
Other
Please Specify
*
Football History: How many years played? What team/organization? Positions Played? Provide as much information as possible about your child's football experience, this will help us decide what level they will train on. All listed skillsets will be verified through screenings and observation over the first month.
*
What position does your child desire to play? Why? (Ask your child)
*
What position do you desire your child to play? Why?
*
What results are you expecting for your player by connecting with CAMP81?
*
Medical Conditions or Allergies: Include any medications that player is currently taking (provide dose, time taken, who is responsible for making sure takes medicine, and does the child take willingly or has to be encouraged).
*
In the event of a medical emergency please provide the following: Who do we contact first if you are not there? What hospital do you prefer should the player need to be taken? Does the player have health insurance?
*
Player's Current Lifestyle: Include what their diet looks like, activity level, social activities, and any other information to help us tailor the training.
*
Player's Education:
*
Current School
Grade
Last Report Period Grade (Passing/Struggling/Failing)
1
Please provide 2 emergency contacts:
*
Full Name
Contact Number
1
2
I agree to the following terms and conditions:Assumption of Risk: I understand that participation in the Camp81 Skills Training program involves inherent risks, including but not limited to physical injury, emotional distress, or not achieving desired results. I acknowledge that these risks cannot be eliminated entirely, and I voluntarily assume all risks associated with my child's participation.Release of Liability: I, on behalf of myself, my child, and our respective heirs, executors, administrators, and assigns, hereby release, waive, and discharge Camp81 Skills Training, its directors, instructors, employees, and agents from any and all claims, liabilities, damages, or expenses arising out of or related to my child's participation in the program, including but not limited to personal injury, property damage, or emotional distress.Indemnification: I agree to indemnify and hold harmless Camp81 Skills Training, its directors, instructors, employees, and agents from any and all liabilities, damages, or expenses, including reasonable attorney's fees, arising out of or related to any claim brought by a third party as a result of my child's participation in the program.Medical Treatment: In the event of any injury or medical emergency involving my child during their participation in the Camp81 Skills Training program, I authorize Camp81 Skills Training staff to obtain medical treatment for my child as deemed necessary. I understand that I am responsible for any medical expenses incurred as a result of such treatment.Photography and Publicity: I grant Camp81 Skills Training the right to use photographs, videos, or other media of my child taken during the program for promotional or educational purposes, without compensation or notification.Acknowledgment of Understanding: I have read and understand the terms of this liability waiver, and I voluntarily agree to be bound by its terms. I acknowledge that I am signing this waiver freely and without any inducement or duress.
My Products
prev
next
( X )
PACKAGE 1
4-1 HOUR SESSIONS/MONTH (4 DAYS)
$
350.00
PLAYERS MONTH(S) OF COMMITMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
PACKAGE 2
3-1 HOUR SESSIONS/MONTH (3 DAYS)
$
260.00
PLAYERS MONTH(S) OF COMMITMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
PACKAGE 3
2-1 HOUR SESSIONS/MONTH (2 DAYS)
$
200.00
PLAYERS MONTH(S) OF COMMITMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
PACKAGE 4
1-1 HOUR SESSION/MONTH (1 DAY)
$
100.00
PLAYERS MONTH(S) OF COMMITMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
Parent's Name
First Name
Last Name
Player's Name
First Name
Last Name
Parent's Signature
Date Signed
-
Month
-
Day
Year
Date
LET'S BALL!
LET'S BALL!
Should be Empty: