College Productions Registration and Consent Form

College Productions Registration and Consent Form
*Please note that a 48-hour notice is required to register your child.

If you have any questions, please contact us via email at antoniowendes@gmail.com or 205-873-2218.
Parent/Guardian Information
Parent/Guardian Name*

First NameLast Name
Relationship*
Phone Number*
Please enter a valid phone number.
Primary Email*
*Important information and updates will be sent to the email address on file.
Parent/Guardian Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
Email
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Information
Child's Name*

First NameLast Name
Child's Gender*
Child's Date of Birth*

MonthDayYear
Child's Age*
Position Interest*
If you are registering more than one child, please fill out the fields below for each child.
Any Known Allergies?*

YesNo
If yes, please list below:
Any Medications?*

YesNo
If yes, please list below:
Other Known Conditions*
*If none, please type N/A
Emergency Contact

The person(s) listed below are authorized to pick up my child or be called in the event of a medical emergency.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship*
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
South Camp Tour Dates

*Please be advised that the camp selection below is strictly for interest documentation ONLY. This Section does not guarantee your attendance and any of the listed camps below. Each camp has a limit of how many participates that will be able to attend. Camp Spots will be filled in the order that we receive all completed and valid registration forms.
Please select the camp(s) you desire to attend*

June 6 Jacksonville State CampJune 8 Tennessee University CampJune 12 Middle Tennessee CampJune 15 Alabama State CampJune 21 South Carolina State CampJune 23 Kansas State Camp
Waivers and Releases
Release statement: The undersigned parent or legal guardian of the child/children listed above hereby consents and authorizes participation with College Productions. I understand that my child/children will engage in a number of sports and activities that require physical exertion and acknowledge that there is a risk of personal injury to my child/children. In consideration for College Productions accepting the above names children participation, I do hereby for myself, my spouse, my children, my heirs, personal representatives and assigns, forever discharge College Productions, its agents, servants, associates, officers, directors, affiliates, sureties, successors, and either in law or equity, arising from or as a result of my child/children's participation and association with College Productions.
Name*

First NameLast Name
Signature*

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Photo/Video Waiver: I knowingly give consent for the release of any photographic images that may be taken during my child’s participation with College Productions at any of the listed Camp events for use by College Productions for its publications, promotional materials, website, social media, advertisement, press releases, and/or any other sanctioned materials. I hereby grant permission to the rights of my child’s image, likeness and without payment or any other consideration. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.
Name*

First NameLast Name
Signature*

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Payment Information

Package Selection

2 Camp Package Includes 1 Position & Skills Training Session

$125.00 Quantity

4 Camp Package Includes 1 Position & Skills Training Session

$240.00 Quantity

6 Camp Package Includes 3 Position & Skills Training Sessions, NIL Mentorship + College Athlete Promotion

$375.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Cash App Pay

ACH Bank Transfer

Should be Empty:

College Productions Registration and Consent Form

Parent/Guardian Information

Child Information

Emergency Contact

South Camp Tour Dates

Waivers and Releases

Payment Information

Payment Methods