Future College Athlete FH College ID Clinic
PLEASE MAKE A NOTE OF WHICH SESSION YOU SIGN UP FOR! SPACE WILL BE LIMITED IN EACH SESSION AND WE CANNOT GUARANTEE THERE WILL BE ROOM TO SWITCH ONCE REGISTERED.
Email address *
PICK A SESSION *
Campers First Name *
Your answer
Campers Last Name *
Your answer
Please list Camper's Primary Position *
Primary position
Your answer
Please list Camper's Secondary Position *
Secondary position
Your answer
Graduation Year in High School *
Campers High School *
Your answer
Campers High School Coach (Name) *
Your answer
Campers High School Coach's email *
Your answer
Camper's date of birth *
Your answer
Camper's GPA *
cumulative
Your answer
Camper's SAT or ACT score *
or date taking
Your answer
Camper's email *
Your answer
Camper's Phone Number *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last name *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Street Address *
Your answer
Parent/Guardian City *
Your answer
Parent/Guardian State *
Your answer
Parent/Guardian Zip Code *
Your answer
Emergency Contact *
Name
Your answer
Emergency Contact *
Relationship to clinic participant
Your answer
Emergency Contact *
phone number
Your answer
Medical Information *
Who is your insurance provider?
Your answer
Medical Information *
Policy number
Your answer
Medical Information *
Doctors Name
Your answer
Medical Information *
Doctors contact information
Your answer
Medical Information *
Does your child have any drug allergies? if Yes specify
Your answer
Medical Information *
Does your child have any food allergies? if Yes specify
Your answer
Medical Information *
Does your child take any medication? if Yes specify
Your answer
Are you paying by check? Clinic fee is $395 if paying by check Please make checks out to Future College Athlete *
Are you paying by credit card? Clinic fee is $395 plus 3% processing tax if paying online with credit card through PayPal *
Cancellation/Refund Policy *
REFUND POLICY: Fees are only refundable if 1) registration is already full at time registration was received 2) camp is canceled, or 3) camper withdraws and a wait listed camper takes their place. In all instances a $25 processing fee will apply. No refunds whatsoever will be made for other circumstances. Both the Registration and Emergency/Medical Forms must be completed for each camper attending Future College Athlete Field Hockey College Coaches Camp before registration is processed. If the registration material is not fully completed, the material will be returned for completion. This will most likely delay enrollment in the camp and could result in the student-athlete being wait-listed.
Required
Assumption of Risk and Release from Liability *
I am the parent or legal guardian of the above mentioned Student Athlete, and I request that my student athlete participate in Future College Athlete Field Hockey College Coaches Camp. As consideration for Future College Athlete allowing my child to participate in the camp, I agree to the terms and conditions of this Agreement. I am not aware of any medical or other reason why my child should not participate in the camp. I acknowledge that this form directs me to advise a Future College Athlete representative immediately if I believe any aspect of the camp’s facilities or equipment to be unsafe, and not to permit my child to participate in the camp if I believe it to be unsafe. I assume all risks arising out of, or relating to, my child’s participation in the camp. I acknowledge that the risks to my child include but are not limited to personal injury (including emotional/psychological harm), serious bodily harm, permanent and temporary disability, and death. I acknowledge that these risks are inherent in the camp and cannot be eliminated. To the fullest extent permitted by law, I voluntarily release and covenant not to sue Future College Athlete and each of its trustees, officers, directors, coaches, and other employees and agents (“the released parties”) from any and all claims and liabilities, whether caused by negligence or otherwise, that arise out of or relate to my child’s participation in the camp. I also understand that I am not releasing the released parties from any injury my child may suffer as a direct result of the released parties’ intentional misconduct or gross negligence.
Required
A copy of your responses will be emailed to the address you provided.
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