Summer Camp Registration

As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me Permission is also granted to the Apt Academy and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Informed Consent and Acknowledgement By signing and submitting this form, I acknowledge that I have read and understood the informed consent disclosure and authorize my child’s participation in the summer camp activities. I understand that participation involves inherent and potential risks, including the possibility of injury, illness, or other harm, and I voluntarily assume all such risks on behalf of myself and my child. I further release and hold harmless Apt Academy and its affiliates, including its directors, coaches, staff, volunteers, and representatives, from any and all claims, liabilities, damages, or causes of action arising out of or related to my child’s participation, except to the extent prohibited by law.