Camp Registration - Budapest - NetScouts Basketball

Camper Name*

First Last

Date of birth*

Parent/Legal Guardian*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Email*

Home Phone

Cell Phone

School/Club Name*

Coaches Name

Medical Conditions/Special Instructions*

Please list any medical conditions or special instructions the Event Administrators should be aware of for the participant

Emergency Contact Name*

Emergency Contact Phone*

Alternate Phone

Assumption and Release of Liability:

In consideration of the NetScouts Basketball Basketball Camps/Clinics granting the individual permission to participate in NetScouts Basketball Camps/Clinics, I hereby assume all risks of his or her personal injury (fatal or otherwise) that may result from any NetScouts Basketball Camps/Clinics activity. As either a Student or Parent/ Guardian I do hereby RELEASE, DISCHARGE AND COVENANT NOT TO SUE NetScouts Basketball, our camp staff or our camp corporate partners and their officers, employees, agents, from all liability, including claims and suits at law or in equity, for loss, damage or injury which arises out of or is related to the participant taking part in NetScouts Basketball Camps/Clinics activities. I understand that any and all cost of medical care deemed necessary for the treatment of my child/ward is my responsibility and the Camp personnel and or NetScouts Basketball nor their camp corporate partners is/are not obligated to pay for medical care. I understand and agree if any illness, injury or medical emergency occurs which, in the sole judgment of the Camp staff (including athletic trainers) is required, I give consent to clinic/camp personnel to provide medical care for my child/ward. I hereby assure and hold harmless the camp staff personnel, NetScouts Basketball and our corporate partners from any and all cost, expenses, damages or liabilities arising from any acts or omissions of staff member/medical care by reason of my child(s)/ward(s) participation in the camp.

Agreement*