Player Name (required)
Age (required)
Position(s) (required)
Parent/Guardian Name (required)
Address (required)
City (required)
State (required)
Zip Code (required)
Home Phone Number (required)
Daytime Phone Number (required)
Your Email (required)
Adult T-Shirt Size (required) S M L XL Youth L
Emergency Contact Name (required)
Relationship to Player (required)
Emergency Home Phone Number (required)
Emergency Daytime Phone Number (required)
All three boxes must be checked in order for registration to be complete.
Release and Waiver of Liability: In consideration for Next Level Foundation permitting our child to participate in its Camp/Clinic, we hereby agree as follows: We agree that Next Level Foundation, its officers, employees, and agents shall not be liable for any injury to the person or property of our child arising out of, or related to our childs presence at the Camps/Clinics premises, his or her participation in any aspect of Camp/Clinic, or occurring while our child is under the care, supervision or responsibility of any Next Level Foundation, officers, agents, and employees, from and against any claims, demands, actions, losses or cause of action whatsoever arising out of or related to any injury to person or damage to property of our child while our child is on the camps premises, participating in any aspect of Camp/Clinic, and /or under the care, supervision, and/or responsibility of any Next Level Foundation, employee or agent, whether such claim, demand, action, loss, or cause of action results from an act or omission, including the negligent acts or omissions, of Next Level Foundation, its officers, employees or agents, or from some other cause, whether foreseeable or unforeseeable. Measures will be taken by staff to maintain order, security, courtesy and protection to all participants and guests throughout the camp/clinic session.
1 Your typed name will serve as your authorizing signature (required)
Consent to Medical Treatment: In the event that Next Level Foundation, in its sole discretion, determines that there is or may be a medical emergency requiring immediate medical treatment for my child, we hereby authorize any office, employee or agent of Next Level Foundation to secure and consent to the transportation and/or treatment of my/our child by any licensed ambulance, physician, hospital, or other medical personnel, and we agree that Next Level Foundation, sponsors, or agents shall NOT be financially responsible for payment of any and all such medical transportation and or treatment.
2 Your typed name will serve as your authorizing signature (required)
Consent to Use: I give my permission to use photographs, videotapes, recording or any other record of my child’s participation in the Next Level Foundation for any purpose. By signing below, as legal guardian for said child, I understand and consent to this statement.
3 Your typed name will serve as your authorizing signature (required)
