2017 WCYF Camp Registration Form
Camp(s) Attending
Please check ALL camps you plan on attending
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Camper's First Name
Your answer
Camper's Last Name
Your answer
Age
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Birthdate
MM
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DD
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YYYY
Entering Grade
School
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Parent/Guardian
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Home Phone
(xxx) xxx-xxxx
Your answer
Cell Phone
(xxx) xxx-xxxx
Your answer
Business Phone
(xxx) xxx-xxxx
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Address
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City
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Zip Code
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Medical Insurance Company
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ID#
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Medical conditions we should be aware of:
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PARENT CONSENT RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT
For good and valuable consideration, including permission for the minor named below ("Minor") to participate in the activity of football lessons, instruction and training and related activities (collectively, the "Activity") and the use, if any, of the property, facilities and equipment of Releases, I, the parent/guardian of Minor, for myself and on behalf of Minor and our respective heirs, personal representatives, successors and assigns:

1. Consent to the Minor's participation in the Activity;

2. Acknowledge that prior to the Minor's participation in the Activity, I will inspect the property, facilities and equipment of Releasees and the area the Activity is being conducted, and, if I believe any of them are unsafe, I will immediately advise the person supervising the Activity of the same;

3. Warrant that the Minor is in good health, has received any medical clearance that may be prudent, and has no physical condition that would prevent the Minor from participating in the Activity;

4. Acknowledge and fully understand that (i) Releasees will rely upon my decision to seek any medical clearance prior to participation in the Activity, (ii) the Activity may or will include physical contact with other participants, and (iii) the Minor's participation in the Activity may involve risk of serious injury or death, including economic losses, which may result not only from the Minor's own actions, inaction or negligence, but also from the actions, inaction or negligence of others, the condition of the property, facilities or equipment of Releasees, or areas where the Activity is being conducted or the type of Activity; and

5.Assume any and all risks of personal injuries to the Minor, and release, waive, discharge and relinquish West Coast Youth Football, LLC, Mark Watson, Chris Jones, the El Dorado Union High School District and all of their respective members, managers, employees, agents, affiliates, subsidiaries, heirs, personal representatives, successors, assigns and insurers (collectively "Releasees") from any and all liability, losses, damages, claims demands or causes of action against Releassees, or any of them, attributable to, arising out of or in any way related to the Minor's participation in the Activity and/or the use of Releasees' property, facilities or equipment, whether the same shall arise by Releasees' negligence or otherwise.

Parent/Guardian Signature: "I have read, understand, and agree to the 'Parent Consent Release and Waiver of Liability and Assumption of Risk Agreement"
Your typed name below is your legal signature.
Your answer
Name of Minor
Your answer
Today's Date
MM
/
DD
/
YYYY
Email Address for confirmation
Your answer
Payment Options
YOUR REGISTRATION WILL NOT BE COMPLETE UNTIL PAYMENT IS RECEIVED.

1. Pay online by clicking the link on this page.

2. Send your check to:
Mark Watson, West Coast Youth Football, LLC
1304 Hartley Way
Folsom, CA 95630

*Make checks payable to: West Coast Youth Football, LLC
*Print Camper's first and last name on Check

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