Gear Up FHC | Register

Contact Information
Name*
First Last
Parent/Guardian Name
Address*
Street Address City State ZIP Code
Home Phone*
Emergency Phone*
Work Phone*
Email*

Participant/Camper Information
Participant/Camper Name*
First Last
Date of Birth*
School*
The school the participant will attend next fall.
Position*
Camp/Clinic Sessions*
Camper Experience Information*
Please tell us more about the campers field hockey experience (How many years have you played, Top Tournaments Attended, Club Team, Other Camps Attended, etc).
Additional Participant/Camper Information
Would You Like To Add Additional Participant/Camper?*
Participant/Camper Name #2*
First Last
Date of Birth*
School*
The school the participant will attend next fall.
Position*
Camp/Clinic Sessions*
Camper Experience Information*
Please tell us more about the campers field hockey experience (How many years have you played, Top Tournaments Attended, Club Team, Other Camps Attended, etc).
Additional Participant/Camper Information
Would You Like To Add Additional Participant/Camper?*
Participant/Camper Name #3*
First Last
Date of Birth*
School*
The school the participant will attend next fall.
Position*
Camp/Clinic Sessions*
Camper Experience Information*
Please tell us more about the campers field hockey experience (How many years have you played, Top Tournaments Attended, Club Team, Other Camps Attended, etc).

Consent Waiver
RELEASE OF LIABILITY – READ BEFORE SIGNING
In consideration of my minor child/ward (“my child”) being allowed to participate in this sport camp program, its related events and activities, I, the undersigned, acknowledge, appreciate, and agree that: 1. The risk of serious injury from the sports activities involved in this program is always present due to the nature of the sport (s); 2. FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child’s participation; and 3. I willingly agree to comply with the program’s stated and customary terms and conditions for my child’s participation. If, however, I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from participation and bring such to the attention of the nearest official immediately; and 4. I, for myself and on behalf of my heirs, assignees, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Camp, Gear Up Field Hockey Camp, Wesley College, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for activity (“Releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, regarding my child and/or arising from his/her activities, WHETHER ARISING FROM NEGLIGENCE OF THE RELEASES OR OTHERWISE, except for willful misconduct, or otherwise to the fullest extent of the law. I HAVE READ THIS HEALTH FORM AND RELATED CERTIFICATIONS, THE RELASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND THEIR TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
I hereby certify that the above-mentioned participant is in good health and fully able to participate in all activities of the Camp. By signing below, I am stating that I am also aware of and accept the risk inherent in the program activity. By signing below, I agree as well to hold harmless and indemnify Gear Up Field Hockey Camp, their officers, agents and employees, and Wesley College, from any and all liability, loss, damages, costs, refunds or expenses which are sustained, incurred or required out of the actions of my dependent in the course of the camp.
I/We Accept The Terms Of The Waiver Above*
- Yes
- No
By checking the box, you have read, understand and agree that you are accepting the terms of the waiver in regards to your child's participation in field hockey at said location. If you do not agree, please check that box and unfortunately, we cannot have your child participate at Gear Up Field Hockey Camps.
Insurance Card*
- Will bring copy
- Camper has copy of card
Please check that you will bring a copy of the campers insurance card with you to camp.
Today's Date*
Enter Your Initials Below To Sign The Waiver*

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Contact Information

Participant/Camper Information

Additional Participant/Camper Information

Additional Participant/Camper Information

Medical Waiver

Medical Waivers

Consent Waiver

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