Adonal Foyle Athletics & Academics Basketball CampsSIGN UP

Participant Registration

Date/Location
 

Participant Name
 

Parent's Name
 

Address
 

City / Zip
 

Phone
 

Age / School
 
/

T-shirt Size
 


PARTICIPANTS RELEASE AND WAIVER

I hereby forever release and discharge Adonal Foyle, Adonal Foyle Enterprises, LLC, Kerosene Lamp Foundation Inc., Athletics & Academic LLC, and their respective agents, affiliates, officers, directors, managers, employees, members, partners, shareholders and representatives from and against any and all liabilities, claims, demands or causes of action for any injury, illness, incident or damage (physical or otherwise) suffered by my child arising out of, or related to, my child's participation in the Adonal Foyle "Athletics and Academics" basketball camp (the "camp"), including, without limitation, my child's travel to and from the camp.

I hereby represent, warrant and covenant that I have no knowledge of any physical or mental impairment that would affect my child's participation in the training session(s).

Further, I hereby authorize staff to act in accordance with their best judgment in any emergency requiring medical attention.

Insurance Company
 

Policy Holder
 

PPO/PPN/HMO/EPO
 

Policy #
 

Group #
 

Physician's Name
 

Physician's Phone
 

Allergies
 

Medication/Dosages
 


EMERGENCY CONTACT

Relationship to Child
 

Address
 

City / Zip
 

Home Phone
 

Work Phone
 

By clicking the button below, you agree to all terms contained in this form. You will be taken to the payment screen after submitting this form.