PHYSICAL TRAINING & TECHNIQUE SUMMER BOOTCAMP REGISTRATION FORM

PHYSICAL TRAINING & TECHNIQUE SUMMER BOOTCAMP REGISTRATION FORM

Location: Doss Park, 2500 Frick Road, Houston, TX 77038 | Camp Dates: June 16 - July 10, 2025 | Schedule: Monday, Wednesday, Thursday | 1:00 PM - 3:00 PM
Participant Information:
Full Name

First NameLast Name
Birth Date

MonthDayYear
Participant's Age
Gender
T-Shirt Size (if applicable)
Parent/Guardian Information
Name

First NameLast Name
Relationship to Participant
Cell Number
Format: (000) 000-0000.
Alternate Number
Format: (000) 000-0000.
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Alt. Phone Number
Format: (000) 000-0000.
Does the participant have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the participant prescribed an inhaler or currently taking any medication? If yes, please explain any instructions.
Primary Physician's Name

First NameLast Name
Physician's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Camp Selection & Payment:
Registration Type:
Payment Method:
Would you like to receive future updates about camps and programs?
Waiver & Release of Liability:

I, Parent/Guardian of the above named Participant, hereby assume all risks associated with my child’s participation in the Physical Training & Technique Summer Camp, including but not limited to risks arising from negligence, carelessness, dangerous conditions, defective equipment, or actions of others.

I certify that my child is physically fit and has not been advised against participation by a medical professional. I acknowledge that this Accident Waiver and Release of Liability will be used by the organizers of the camp and will govern my child’s participation.

In consideration of my child’s enrollment, I agree to the following:

(A) WAIVER & RELEASE – I release and discharge the camp organizers, coaches, agents, volunteers, and staff from all liability for my child’s injury, disability, death, property damage, or other loss arising from participation in the program.

(B) INDEMNIFICATION – I agree to hold harmless and not sue the camp organizers, coaches, agents, or volunteers for any claims or damages related to my child’s participation, whether caused by negligence or otherwise.

(C) ASSUMPTION OF RISK – I understand that participation involves physical activity that carries the potential for serious injury, including but not limited to falls, collisions, dehydration, and environmental conditions. I voluntarily assume these risks.
(D) PHOTO & MEDIA CONSENT – I grant permission for the camp to take photos/videos of my child during participation for training and promotional purposes.
Parent/Guardian Initials:
Medical Release and Authorization

In the event of a medical emergency, I authorize the camp organizers, coaches, agents, and representatives to obtain and provide emergency medical treatment for my child if necessary. I understand that every effort will be made to contact me or my emergency contact before initiating medical care. If I cannot be reached in an emergency, I authorize camp staff to consent to medical treatment, including but not limited to, transportation by ambulance, administration of first aid, hospitalization, surgery, anesthesia, and medications as recommended by a licensed medical professional.

I understand that I am responsible for any medical expenses incurred as a result of my child’s participation in the camp.
Parent/Guardian Initials:
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I certify that I am the Parent/Legal Guardian of the above name Participant and that I understand and agree to all terms of this waiver.

This consent is given freely and voluntarily.

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.
Parent/Guardian Name

First NameLast Name
Date

MonthDayYear
Date
Signature
Should be Empty:

PHYSICAL TRAINING & TECHNIQUE SUMMER BOOTCAMP REGISTRATION FORM

Participant Information:

Camp Selection & Payment:

Waiver & Release of Liability: