Volleyball Camp Signup
Camper Date of Birth
Camper Grade as of September 2020
Camper Age as of July 1
Parents Cell Phone
I give permission for my son/daughter to participate in the WH Athletic Camp/Clinic. I agree to hold the Whitman-Hanson School District and all of its employees and agents, Bob Rodgers, Samantha Richner, all coaches, camp counselors, officials, trainers and agents free from any liability whatsoever in the event of any type of injury or contraction of Covid 19; I also certify that my son/daughter has been through a physical examination within the last 13 months and that he/she is healthy and able to participate in the camp. I also give my permission for the program to seek medical attention for my son/daughter in the event of an injury, but again will not hold the camp, its coaches, Whitman-Hanson Regional School District or its agents liable for said medical care or lack there of. I am aware that attending this program could put family members at risk in terms of the transmission of Covid 19. I affirm that I understand these risks and will not hold Whitman-Hanson Regional School District, its employees, its agents or any other party liable for any issues that may arise as a result of attending this program. By printing my name below I agree to all of the above provisions
Please describe any medical concerns
Please list any emergency contacts (name and number)
Send me a copy of my responses.
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This form was created inside of Whitman-Hanson Regional School District.