Top Achievers Ultimate Summer Camp Registration

Parent/Guardian Full Name

First NameLast Name

Parent/Guardian Email Address

example@example.com

Parent/Guardian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Name (This person will be called to pick up in case of an emergency or inability to reach person filling out the form).

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Child Registration

What days do you anticipate your child(ren) attending?

I authorize Top Achievers to use photographs, video recording, and/or audio recordings of my child for educational, promotional, marketing, and fundraising purposes.

Please acknowledge the following:

Release, Waiver, and Hold Harmless Agreement

Assumption of Risk and Release of Liability

I, the undersigned parent or legal guardian, understand that participation in the Top Achievers Ultimate Summer Camp may involve physical activities, recreational activities, sports, field trips, and other program-related experiences that carry inherent risks of injury, illness, property loss, or other unforeseen circumstances.

On behalf of myself and my child, I voluntarily assume all risks associated with participation in the program.

In consideration for my child's participation, I agree to release, waive, discharge, and hold harmless Top Achievers, its officers, directors, employees, volunteers, agents, representatives, sponsors, and partners from any and all claims, demands, causes of action, damages, liabilities, costs, or expenses arising out of or related to my child's participation in the program, except to the extent caused by gross negligence or willful misconduct.

I further agree to release, waive, discharge, and hold harmless Plano Independent School District ("Plano ISD"), its Board of Trustees, officers, employees, agents, and representatives from any and all claims, demands, causes of action, damages, liabilities, costs, or expenses arising out of or related to my child's participation in Top Achievers activities conducted on or utilizing Plano ISD facilities.

I understand that Top Achievers is an independent organization and that Plano ISD is not sponsoring, supervising, operating, or responsible for the administration of the program.

I certify that my child is physically able to participate in camp activities and that I have disclosed any known medical conditions, allergies, or limitations that may affect participation.

By signing below, I acknowledge that I have carefully read and understand this Release, Waiver, and Hold Harmless Agreement and voluntarily agree to its terms.

Parent Signature