MACMURRAY COLLEGE July 18, 19 & 20, 2016 PARENT/GUARDIAN RELEASE FOR SPORT CAMP In consideration of the educational opportunity that is afforded, the undersigned agrees as follows: “Camper” is _____________________________, whose date of birth is:_________________. “Operator” is : MacMurray College. “Liabilities” shall mean any and all known and unknown, foreseen and unforeseen, claims, actions, suits, proceedings, damages, costs, attorney fees, litigation costs, and other expenses arising out of, connected with, or resulting from participation in the Sport Camp, including claims for personal injury or death. “Parent/Guardian” is __________________________________, who can be contacted at________________________. “Releasees” include Operator, its officers, employees, agents, volunteers, and representatives; and in consideration of the camp being offered at its premises, Releasees include The Board of Trustees of MacMurray College, its affiliated foundations, trustees, officers, employees, agents, volunteers, and representatives. “Sport Camp” shall mean all activities involved in the Sport Camp, and all related activities, such as housing, dining, and transportation, whether of- fered by Operator or its contractors. Release. Parent/Guardian hereby knowingly and voluntarily releases, exculpates, and discharges Releasees from any and all Liabilities related to the Sport Camp. This is intended to discharge in advance the Releasees and waive all Liabilities related to Camper’s participation in the Sport Camp. Assumption of Risk. Parent/Guardian understands that Camper’s participa- tion in the Sport Camp is wholly voluntary, and that participation involves risk. These risks include, without limitation, risks involved in traveling to and returning from sites where activities are to take place; risks from premises involved, including those that are owned by others; risks such as falls or other accidents; risks from the areas where activities are to take place; risks from other workers and participants involved in the Sport involved, such as risks from collisions, sports injury, or equipment; other risks inherent in any strenuous activities; risks from weather; risks from dining, housing, and transportation; and other risks beyond the control of the Operator or others, including Releasees. Parent/Guardian has conducted, or has had the op- portunity to conduct, his/her own investigation and is willing to accept these risks. Parent/Guardian understands and acknowledges that involvement and participation in the Sport Camp may cause Camper to suffer and injury, severe health problems, or even death, and Parent/Guardian assumes and accepts any and all such risks. Health Care and Emergencies. Parent/Guardian understands that neither Operator nor Releasees accept responsibility or liability for providing health care services or health care insurance for Camper in regard to Sport Camp, and that Liabilities related to health care remain the Parent/Guardian’s responsibility. Parent/Guardian agrees that if Camper has any medical or mental condition that could impact the welfare or safety of Camper or oth- ers, such information can be timely disclosed, to help ensure the safety and well being of Camper and others. In the case of a medical emergency, Par- ent/Guardian authorizes Operator to give consent for medical treatment on Camper’s behalf, including all ordinary and extraordinary medical measures. Indemnification. Parent/Guardian shall release, hold harmless, and in- demnify Releasees from and against any and Liabilities related to the Sport Camp, including medical care decisions. Acknowledgement. Parent/Guardian has read and relies wholly upon his own judgment and knowledge, in agreeing to this document; warrants that he has legal responsibility, custody, and authority to speak for the minor Camper, and binds himself, Camper, and their heirs, assigns, and next of kin. Emergency Contact Name:_______________________________________ Contact Number::_______________________________________________ Signature of Parent/Guardian: ________________________Date: _______ CAMP WAIVER 447 East College Avenue Jacksonville, Illinois 62650 Basketball Office 217-479-7155 Coach Todd Creal & Coach Derek James www.mac.edu Bill Wall Gymnasium YOUTH BASKETBALL ACADEMY Current local Mac players: Lance Buhlig - Payson Seymour HS Michael Cameron - Pleasant Plains HS Andrew Davis - North Greene HS Hunter Flessner - Payson Seymour HS Tim Frazier - Springfield Lanphier HS Zach Hibbert - Camp Point Central HS Brent Long - Jacksonville Routt HS Taten Musso - North Macoupin HS Jake Voss - Payson Seymour HS
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MACMURRAY COLLEGE
July 18, 19 & 20, 2016
PARENT/GUARDIAN RELEASE FOR SPORT CAMP In consideration of the educational opportunity that is afforded,
the undersigned agrees as follows:“Camper” is _____________________________, whose date of birth is:_________________.“Operator” is : MacMurray College. “Liabilities” shall mean any and all known and unknown, foreseen and unforeseen, claims, actions, suits, proceedings, damages, costs, attorney fees, litigation costs, and other expenses arising out of, connected with, or resulting from participation in the Sport Camp, including claims for personal injury or death. “Parent/Guardian” is __________________________________, who can be contacted at________________________.“Releasees” include Operator, its officers, employees, agents, volunteers, and representatives; and in consideration of the camp being offered at its premises, Releasees include The Board of Trustees of MacMurray College, its affiliated foundations, trustees, officers, employees, agents, volunteers, and representatives.“Sport Camp” shall mean all activities involved in the Sport Camp, and all related activities, such as housing, dining, and transportation, whether of-fered by Operator or its contractors.Release. Parent/Guardian hereby knowingly and voluntarily releases, exculpates, and discharges Releasees from any and all Liabilities related to the Sport Camp. This is intended to discharge in advance the Releasees and waive all Liabilities related to Camper’s participation in the Sport Camp.Assumption of Risk. Parent/Guardian understands that Camper’s participa-tion in the Sport Camp is wholly voluntary, and that participation involves risk. These risks include, without limitation, risks involved in traveling to and returning from sites where activities are to take place; risks from premises involved, including those that are owned by others; risks such as falls or other accidents; risks from the areas where activities are to take place; risks from other workers and participants involved in the Sport involved, such as risks from collisions, sports injury, or equipment; other risks inherent in any strenuous activities; risks from weather; risks from dining, housing, and transportation; and other risks beyond the control of the Operator or others, including Releasees. Parent/Guardian has conducted, or has had the op-portunity to conduct, his/her own investigation and is willing to accept these risks. Parent/Guardian understands and acknowledges that involvement and participation in the Sport Camp may cause Camper to suffer and injury, severe health problems, or even death, and Parent/Guardian assumes and accepts any and all such risks. Health Care and Emergencies. Parent/Guardian understands that neither Operator nor Releasees accept responsibility or liability for providing health care services or health care insurance for Camper in regard to Sport Camp, and that Liabilities related to health care remain the Parent/Guardian’s responsibility. Parent/Guardian agrees that if Camper has any medical or mental condition that could impact the welfare or safety of Camper or oth-ers, such information can be timely disclosed, to help ensure the safety and well being of Camper and others. In the case of a medical emergency, Par-ent/Guardian authorizes Operator to give consent for medical treatment on Camper’s behalf, including all ordinary and extraordinary medical measures. Indemnification. Parent/Guardian shall release, hold harmless, and in-demnify Releasees from and against any and Liabilities related to the Sport Camp, including medical care decisions.Acknowledgement. Parent/Guardian has read and relies wholly upon his own judgment and knowledge, in agreeing to this document; warrants that he has legal responsibility, custody, and authority to speak for the minor Camper, and binds himself, Camper, and their heirs, assigns, and next of kin.
Emergency Contact Name:_______________________________________
Contact Number::_______________________________________________
Signature of Parent/Guardian: ________________________Date: _______
CAMP WAIVER
447 East College AvenueJacksonville, Illinois 62650
Basketball Office 217-479-7155Coach Todd Creal & Coach Derek James
www.mac.edu
Bill Wall Gymnasium
YOUTH BASKETBALL ACADEMY
Current local Mac players:Lance Buhlig - Payson Seymour HSMichael Cameron - Pleasant Plains HSAndrew Davis - North Greene HSHunter Flessner - Payson Seymour HSTim Frazier - Springfield Lanphier HSZach Hibbert - Camp Point Central HSBrent Long - Jacksonville Routt HSTaten Musso - North Macoupin HSJake Voss - Payson Seymour HS
CAMP INFORMATION
CAMPER INFORMATION
Name _______________________________________
Grade entering _______________________________
Address _____________________________________
City ____________________ State ___ Zip _______
E-mail _______________________________________
Phone ______________________________________
T-shirt Size: __ Youth lg __ Adult sm __ Adult med
__ Adult lg __ Adult xl
Parent/ Guardian Name _______________________
Emergency Contact Name _____________________
Emergency Contact Number ___________________
Day-of walk-ups who are not preregistered will be accepted, ONLY if accompanied by a parent or guardian.
If you have any questions, please feel free to call the Basketball Office/Coach Creal at 217-479-7155 or e-mail [email protected].
Please make checks payable to:MacMurray College BasketballAttn: Coach Creal447 East College AvenueJacksonville, IL 62650
This 3 day camp is open to all boys entering grades 1 through 8. Campers will work with the MacMurray College Men’s Basketball coaches and players and learn different skills such as shooting, ball handling, footwork, fundamental defense, fundamental offense, and much more at the MacMurray College Wall Gymnasium.
MacMurray College Head Coach Todd Creal brings more than 18 years of basketball camp experience working camps all over the state of Illinois. The academy will stress fundamentals of basketball and teach drills and habits that will help young players be better players and learn to love the game. The academy will also include individual attention from the Highlander coaching staff and current Highlander players.
Your son will enjoy learning the fundamentals in a fun and entertaining environment from local area players who grew up going to camps like this one. There will be camp awards for best free throw shooter, Hot Shot winner and Beat the Buzzer winner in each age division.
We’re excited to see you in July!
Todd CrealHead CoachMacMurray College Basketball
2015 Highlander Youth Basketball AcademyDates: Monday, July 18, Tuesday, July 19 & Wednesday, July 20Time: 5:00 pm to 8:00 pm Registration begins at 4:00 pm on July 18Place: Wall Gymnasium, Ed Complex MacMurray College campus Hardin Avenue Jacksonville, IL 62650 (campus map may be accessed at: http://www.mac.edu/campus/map.asp)Cost: $60 per student by July 11, 2016 (register by July 11 to receive a t-shirt) $70 per student after July 12, 2016 Additional child in family - $10 offCampers:Entering 1st through 8th gradersT-Shirts: Youth - L; Adult - S, M, L, XLBring: Campers should wear a t-shirt, basketball shorts & tennis shoes. Bring a great attitude and come ready to learn and have fun!Staff: MacMurray coaching staff Current MacMurray players Certified Athletic Trainer on siteDrinks: Water will be provided.Waiver: Must be signed before allowed to participate!
CAMPREGISTRATION
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