Back-to-School Basketball Camp

Back-to-School Basketball Camp

Our camp is Monday-Friday, August 10 - 14 from 9:00a - 1:00p. Lunch will be provided at 12:30. Pickup is at 1:00.
Camper's Name

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Camper's Date of Birth

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Parent Name

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Parent Contact Info
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THE SALVATION ARMY - DIVISION
MINOR PARTICIPATION AUTHORIZATION AND WAIVER
I,   First Name   Last Name authorize   First Name   Last Name  (the Participant) to participate in The Salvation Army Back-to-School Basketball Camp.

I represent and warrant that the Participant is in good health and of sufficient physical fitness to participate in the Activity, and I do not know of any physical condition which would prevent the Participant's participation, cause harm to the Participant, or cause harm
to others. I understand that participation in the Activity places the Participant at risk for serious personal injury, including death, and loss resulting from any number of factors including, but not limited to, the physical condition of the facility, use of equipment, weather that
may be experienced, and conduct of other participants. In addition, the Activity poses the following specific risks:   Signature   .
In consideration for the Participant's opportunity to participate in the Activity, I agree, to the maximum extent permitted by law, on behalf of myself and on behalf of the Participant, as well as our estates and assigns, to WAIVE AND RELEASE The Salvation Army and its officers, directors, employees, agents, and volunteers from and all liability, claims, demands, suit, including without limitation any injury, loss, or damage to property or person, including death, arising from or in connection with Participant's participation, it being
expressly agreed that such waiver and release includes negligence on the part of The Salvation Army. I hereby authorize the employees, volunteers, and agents of The Salvation Army to provide reasonable and necessary emergency medical treatment for the Participant while the Participant is participating in the Activity, if The Salvation Army determines in its discretion that such treatment is necessary. I further agree to pay for any such reasonable and necessary medical treatment upon
presentation of the medical provider's bill or statement. I accept full financial and legal responsibility for the Participant's conduct during participation.
D I understand transportation to, from, and during the Activity will not be provided. Initials:   Signature
D I hereby authorize the employees, volunteers, and agents of The Salvation Army to provide transportation for the Participant in a motor vehicle owned, leased, or rented by The Salvation Army, during the Participant's participation in the Activity. I understand that transportation in a motor vehicle places the Participant at risk for serious personal injury,
including death, and loss. Initials:   Signature   _______ .
In consideration for The Salvation Army providing transportation for the Participant, I agree on behalf of myself and on behalf of the Participant, as well as our estates and assigns, to relieve The Salvation Army and its officers, directors, employees, volunteers, and agents from any and all liability, including without limitation negligence, in connection with any injury, loss, or damage to person, including death, or any injury, loss, or damage to property in connection with Participant's
transportation, to the maximum extent permitted by law. Initials:   Signature   _______.
I understand that by signing this Participation and Authorization Waiver, I give up my right and the Participant's right to sue The Salvation Army. I agree that if any provision or part of any provision or the application of such is held invalid, illegal, or unenforceable, the validity of all other provisions in this Participation and Authorization Waiver shall remain unaffected.
Signature Date   Date
Printed Name and Relationship Emergency Phone
First Name   Last Name   Area Code   Phone Number
Address City, State ZIP
Street Address   Address Line 2   City   State   Zip
Additional Contact: Printed Name and Relationship Emergency Phone
Photo Release

THE SALVATION ARMY
a California nonprofit religious corporation
30840 Hawthorne Blvd.,
Rancho Palos Verdes, California 90725

This will confirm the understanding between the undersigned ("I" or “me”) and THE SALVATION ARMY, a California religious corporation
("you") regarding the creation of one or more audiovisual productions (collectively, the "Programs"). Unless otherwise indicated below, I
represent to you that I am at least 18 years old.
For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby authorize and permit you to use in the Programs
and in any advertising, promotion and publicity: my name and voice, biographical information concerning me, and my portrait and likeness,
including, without limitation, any statements, interviews or performances by or with me, whether as contained in existing photography or as
photographed by you (collectively, "Name and Likeness") and any materials I may furnish in connection with any such interviews or otherwise
(e.g., articles, memorabilia, etc.) (collectively, "Content"); and to reproduce, distribute, transmit, adapt, publicly display, publicly perform, and
otherwise exploit the Programs and to exploit all allied, subsidiary and ancillary rights therein and thereto, by any and all means and media,
whether now known or hereafter developed, throughout the world in perpetuity, provided that nothing shall obligate you to (a) use my Name and
Likeness and/or the Content and/or (b) produce any of the Programs. I release you from any claims that I or any person claiming through me
may have against you at any time relating to the foregoing uses. You shall have the right to edit, modify, add to and/or delete any or all of the
material contained in the Programs, including material that contains my Name and Likeness and/or the Content, in whole or in part. I
understand that I will receive no further compensation for any of these uses. I represent that I own all right, title and interest in and to the
Content and the exploitation thereof hereunder shall not infringe upon the rights of any person or entity.

I hereby release you and your officers, directors, employees, attorneys, agents, representatives, shareholders, successors, licensees and
assignees (collectively, “Released Parties”) from any and all claims, demands, losses, liabilities, actions, causes of action, costs and expenses
including, without limitation, attorneys' fees and costs (collectively, “Claims”), arising out of or in connection with use of the Name and Likeness
and Content, including, without limitation, any and all claims for invasion of privacy, infringement of rights of publicity, defamation (including libel
and slander) and any other personal and/or property rights. I further release the Released Parties from any and all Claims arising out of any
harm, illness, bodily injury and/or death resulting from my participation in the Programs. Furthermore, I hereby agree to save, indemnify and
hold the Released Parties from any and all Claims arising out of any breach by me of any provision of this release.

I agree not to disclose to any third party the terms of this release without your consent, except if required by law. Furthermore, I agree not to
directly or indirectly circulate, publish or otherwise disseminate any news, story, article, book or other publicity concerning the Programs, you or
any third party related to you or the Programs without your prior written consent.
You may assign your rights and obligations contained in this release and agreement to any third party. This release and agreement will be
governed by the laws of the State of California applicable to agreements made and to be entirely performed in that state, and may not be
modified except in a writing signed by me and by you. The rights granted to you in this release are irrevocable; in no event shall I have the right
to seek to enjoin the development, production, distribution, exploitation, advertising or promotion of the Programs or the exercise of any rights
granted to you in this release. I have read this release and I understand it.
I am the custodial guardian of   First Name   Last Name   ,   Date of Bith   . I have read the provisions of this document and hereby approve of and agree to such provisions and further agree to guarantee my child’s obligations hereunder.
Signature:   Signature
Print Name:   First Name   Last Name
Phone Number:         Area Code   Phone Number
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