2019-2020 PRO Camps & Choreography Athlete Waiver & Release Agreement
This PRO Camps & Choreography Athlete Waiver & Release Agreement (“Participant Agreement”) is to be completed and signed by a PARENT or LEGAL GUARDIAN of the said participant.
Participant & Parent/Legal Guardian Section
Please read carefully and complete with the most appropriate response.
Full PROGRAM Name:
(The complete name of your gym, school or organization. The specific request for team name is next.)
Athlete/Participant's Specific TEAM NAME:
(example: Teal, Stars, J5, Coed, Varsity, JV, Freshmen, etc...)
Athlete/Participant's FIRST Name:
Athlete/Participant's LAST Name:
Athlete/Participant's Date of Birth:
Emergency Contact Name
Emergency Contact Cell Phone
Insurance Carrier & Insurance #
Parent/Legal Guardian Waiver Release Acknowledgement Section
All athletes participating in any PRO Camps & Choreography service or activity will need to have a PARENT or LEGAL GUARDIAN (unless 18 years of age or older) fill out the required information below. Completed Participant Waiver and Release Agreements must be received prior to the start of any/all services. No exceptions.
By signing, I, the undersigned parent/legal guardian do hereby give permission for my child/charge to attend and participate in the aforementioned PRO Camps & Choreography, LLC event, service or camp/choreography activity. I understand that by attending and participating in any event, service, or camp/choreography activity provided by, sponsored by, or involving PRO Camps & Choreography, LLC there is a possibility of danger, physical illness, bodily injury or death. On behalf of my child/charge, I hereby waive, acquit, release and forever discharge PRO Camps & Choreography, LLC, its assigns, owners, directors, successors, staff, employees, agents, insurers, subsidiaries, predecessors, affiliates, consultants, sponsors, and the venue/facility of the service being provided (the "Released Parties") from all claims, actions, causes of action, compensation, damages, known or unknown, whether based in tort (to include, but not be limited to negligence, recklessness, gross negligence, or wantonness of any participant or Released Party), contract, statute, strict liability, or any other theory of recovery, that my child/charge ever had, now has, or which may hereafter accrue or otherwise be acquired, against PRO Camps & Choreography, LLC arising out of my child's/charge's participation, attendance, or involvement in any PRO Camps & Choreography, LLC event, service, or camp/choreography activity. I agree that if I or anyone on my behalf asserts a claim contrary to what I have agreed to herein, the claiming party shall be liable for the expenses (including legal fees) incurred by the Released Parties in defending such claim. This agreement may not be modified orally, and a waiver or modification of any provision shall not be construed as a waiver or modification of any other provision herein or as consent to any subsequent waiver or modification. Every term and provision of this agreement is intended to be severable. If any portion of this agreement is found to be unenforceable or invalid, that shall not affect the other terms and provisions, which shall remain binding and enforceable. Further, I hereby authorize representatives of PRO Camps & Choreography, LLC to act for my child/charge, according to their judgment, in any emergency requiring medical attention. Further, I hereby give permission for my child/charge to be photographed, videotaped and/or audio taped to be used in print or broadcast media as deemed appropriate for marketing or promotion of any PRO Camps & Choreography, LLC service/activity and for publicity surrounding participation in any of these services.
ONLY ONE ONLINE FORM PER PARTICIPANT IS REQUIRED ONLY VIA ONLINE SUBMISSION. Paper copies of this form will not be accepted.
PARENT or LEGAL GUARDIAN First & Last Name:
This will co-serve as consent to the above Agreement.
Waiver & Release Acknowledgement
This 2018-2019 PRO Camps & Choreography Athlete Waiver & Release Agreement (“Participant Agreement”) is to be signed by only the PARENT or LEGAL GUARDIAN of the named participant. By signing this Participant Agreement, you, as PARENT or LEGAL GUARDIAN of the participant, are indicating that you have read and agree to all of the terms set forth herein. Underage participants are not permitted to sign form on behalf of their PARENT or LEGAL GUARDIAN. If PRO Camps & Choreography determines, at any time, that a participant has signed the Participant Waiver, the Participant shall be disqualified from the program and all payments shall be forfeited. WAIVER DISCLAIMER: If PARENT or LEGAL GUARDIAN fails to provide accurate and complete waiver information, PARENT or LEGAL GUARDIAN shall assume full responsibility for any participant injuries not covered by WAP waiver.
A copy of your responses will be emailed to the address you provided.
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