Summer Playbook for Success

Get ready for the ultimate summer kickoff on Tuesday, July 1st!

RMIII Foundation and Tampa Family Health Centers (TFHC), led by NFL wide receiver Ray-Ray McCloud III of the Atlanta Falcons, are teaming up to bring the Summer Playbook for Success Sports Camp & Block Party to the Martin Luther King Center.

The sports camp is designed for the youth of the Building Hope Program of the Tampa Housing Authority (THA), in partnership with the City of Tampa Parks & Recreation — giving students a fun, active, and inspiring start to their summer break.

As part of the day, the block party will bring added fun with games, music, food, and summer celebration activities for the program participants.

Don’t miss it — your playbook for a summer full of wins!

Child's Name*

First NameLast Name

Child's Age*

Child's Shirt Size*

Child's Shoe Size*

Parent's Name*

First NameLast Name

Phone Number*

E-mail

example@example.com

Emergency Contact Name*

First NameLast Name

Phone Number*

Do you currently have a medical home (primary care doctor) for your family?*

YesNo

If no, would you be interested in becoming a TFHC patient?*

YesNo

PHOTO, VIDEO, AND SOCIAL MEDIA RELEASE

I hereby grant permission to Tampa Family Health Centers (TFHC), the RMIII Foundation, and their agents, representatives, employees, partners, and authorized media outlets to photograph, record, videotape, and/or digitally capture my likeness, voice, and/or statements in connection with participation in the Summer Playbook for Success Sports Camp & Block Party and related activities.

I authorize the use, publication, distribution, and reproduction of these photographs, videos, recordings, and/or digital images in any medium, including but not limited to print publications, websites, social media platforms, promotional materials, news releases, and other communications, without compensation or further approval.

I understand that these materials will become the property of TFHC and the RMIII Foundation and may be used indefinitely for lawful purposes to promote and support their programs, services, and initiatives.

I hereby waive any rights to inspect or approve the finished product wherein my likeness appears. I release TFHC, the RMIII Foundation, and their agents from any claims, demands, and liabilities in connection with the use of these materials.

Signature (If participant is under 18, Parent/Guardian Signature)*

WAIVER AND RELEASE OF LIABILITY

This Waiver and Release of Liability (“Release”) is executed by the undersigned participant (or the parent/legal guardian if the participant is under 18) in favor of Ray-Ray McCloud III, Tampa Family Health Centers, the RM III Foundation, and their respective directors, officers, employees, volunteers, agents, affiliates, successors, and assigns (collectively, the “Released Parties”).

1. Assumption of Risk
I understand that participation in the Summer Playbook for Success Sports Camp & Block Party may involve physical activity and other inherent risks of injury, whether caused by myself or others. I voluntarily assume full responsibility for any risk of bodily injury, illness, death, or property damage arising out of or related to my participation, whether caused by negligence or otherwise.

2. Waiver and Release
I hereby release, waive, discharge, and hold harmless the Released Parties from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me while participating in the Camp, or while in, on, or upon the premises where the Camp is being conducted.

3. Indemnification
I agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or cost, including court costs and attorneys’ fees, that they may incur due to my participation in the Camp.

4. Medical Treatment
I authorize the Released Parties to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care, and I agree to be responsible for payment of any and all medical services rendered.

5. Binding Effect
This Release shall be binding upon me and my heirs, executors, administrators, and assigns. I acknowledge that I have read and fully understand this Release and agree to be bound by its terms.

Name of Participant*

Signature (If participant is under 18, Parent/Guardian Signature)*