Dr. Motivate CHEER & DANCE BOOTCAMP. Next Camp Date: Sunday, June 23rd

Parent Name*

First NameLast Name

Phone Number*

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Parent Email*

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Student-Athlete Name*

First NameLast Name

Additional Student-Athlete Name (Please only use if you are registering multiple student-athletes)

First NameLast Name

Additional Student-Athlete Name (Please only use if you are registering multiple student-athletes)

First NameLast Name

Early Childhood - 6th Grade (7th graders are eligible if they are 11 as of September 1, 2024)*

WAIVER, RELEASE, PHOTO USE RELEASE FORM and INDEMNITY AGREEMENT - I, the undersigned, being the parent, volunteer or participant involved in the Dr. Motivate LLC. youth sports or summer program project (the “Project”), or being the legal guardian of such a participant in the Project, in consideration of my or another’s participation in the Project, release, defend, indemnify and hold harmless Dr. Motivate LLC., its directors, officers, employees, contractors, volunteers, agents, representatives, invitees, and affiliates (“Dr. Motivate group”) from and against all liability, claims, losses, damages, punitive damages, costs, expenses, attorney's fees, demands, suits and causes of action of every kind and character arising in favor of myself, my child or participant in the Project or anyone claiming thereunder for personal injury, or death, or property damage in anyway incident to or arising out of participation in activities associated with the Project regardless of and expressly including the sole, joint, or concurrent negligence, gross negligence, statutory fault, or negligence per se of any party, including the members of the Dr. Motivate group. I (authorized person signing), hereby grant and authorize Dr. Motivate group the right to take, edit, alter, copy, exhibit, publish, distribute and make use of any and all pictures or video taken of me or the program participant(s) and/or for legally promotional materials including, but not limited to, newsletters, fundraising letters, flyers, posters, brochures, submissions to journalists, websites, social networking sites, annual reports, press kits and other print and digital communications, without payment or any other considerations. This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing. If revoked no pictures from the day of notice moving forward will be used. Pictures taken prior to notice will not be subject for removal. I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.*

Student-Athlete Photo. Photos submitted or taken during the event could be used to welcome student-athletes and or to promote events through Dr. Motivate LLC and or Donald Brown Developmental League Sports Programs. Dr. Motivate LLC is a program sponsor for the Donald Brown Developmental League Sport Programs. By submitting an image, the parent/guardian gives the program and its affiliates permission to use the photo on social media platforms and promotional advertisements without financial obligation now and into the future.

I am interested in enrolling my participants in Dr. Motivate's Summer Leadership Workshops. Could you please provide me with additional information via email? Thank you.*

Yes, please send me the information.No, I’m not interested.Thank you, I have already requested the information.

My Products

Camp DonationWe believe in ensuring that every child is granted the invaluable opportunity to partake in meaningful activities. Through your generous contribution, we are able to extend this privilege to children whose families face financial obstacles. With your donation, we can provide sponsorship for a minimum of three underserved children, opening doors of opportunity for them. Your support, no matter the amount, plays a pivotal role in making a significant impact. We sincerely appreciate your generosity in helping us fulfill this mission. Gratefully, Dr. Brown.

$30.00 Quantity

Dr. Motivate TuffMan Hoodie Est. 2023

$25.00

Size	Quantity	Price
XS		$25.00
S		$25.00
M		$25.00
L		$25.00
XL		$25.00
2XL		$25.00
3XL		$30.00
4XL		$35.00

Camp Fee"The camp fee is non-refundable and non-transferable in the event of a participant's absence. Dr. Motivate LLC retains the right to decline service. We are pleased to inform you that all ICJP Fall 2024 participants currently registered are sponsored by Dr. Motivate LLC for this camp. Both participants and sponsored individuals must complete pre-registration in order to attend. Parents and guardians, we are excited to provide our services to your young student-athletes."

$10.00 Quantity
Item subtotal:$0.00

Total

$0.00

Credit Card

PRE-REGISTRATION Required for Each Dr. Motivate CHEER & DANCE BOOTCAMP June 23rd. Camp Fee is $10 for participants who are not registered for the Fall 2024 CHEER & DANCE Season.

Credit Card