Tampa Girl's Basketball Camps

Registration Form
Fill in the fields, print out and mail to TJ Hoops Inc., 13792 Marseilles Ct., Clearwater, FL 33762
*Make Checks or Money Orders  payable to TJ Hoops Inc.

Name:     Age:      Grade as of 8/10: 
Address:  City:    State:      Zip:
Home Phone #:    Emergency Phone #: 

Email Address: 

School:        City:       State:      Zip:    

Coach:      Coaches Phone #:            

T-shirt size (choose one):     (T-shirts are adult sizes)

Please Indicate your Tampa Girl's Basketball Camp sessions/ date(s), as well as resident/commuter:  (Check as many boxes as needed)

 Team Camp                            June 11-13   $450 Registration

  All Skills                             June 14-18     $190 Registration (day camp only)

All Skills                             Aug 2-6          $190 Registration  (day camp only)

  Elite Camp                           Aug 6-8         $210 Commuter $260 Overnight

   All Skills                           Aug  9-13       $190 Registration (day camp only)

   All Skills                          Aug  16-20       $190 Registration (day camp only)

Total Due (add amounts of each camp selected)             Check #:______________
Total Deposit ($100 per camper, per camp)

Please fill in all of the information below on the release after you have printed out the registration form.

TJ Hoops Inc. - Tampa Girl's Basketball Camps

Release, Consent and Emergency Authorization form

In consideration of being allowed to participate in any way in the Tampa Girl's Basketball Camp, related events and activities, the undersigned acknowledges, understands and agrees as follows:

 

1. I/we [name] ____________________________ of [address] ________________________________________________________,

City of _______________________________________, County of _________________________________, State of ___________ ("Releasors"), am/are the parent(s) or legal guardian(s) on the minor child, ______________________________________________ ("Camp Participant") and represent to the Tampa Girl's Basketball Camp that the facts set forth in this agreement concerning the Camp Participant are true.

 

2. I/we am/are aware and familiar with the many ordinary and hazardous risks involved in sports including, but not limited to, travel to and from the site of activity, physical contact and the possible reckless conduct of other participants.  I/we understand that the dangers and risks of participating in sports and related events and activities include but are not limited to, death, serious neck or spinal injury which may result in paralysis, brain damage, serious injury to all internal organs, injury to all bones, ligament, muscles, tendons, and other aspects of the body.  I/we understand that the dangers and risks of participating in Tampa Girl's Basketball Camp may result not only in serious injury, but in serious impairment of future ability to earn a living, engage in business, and generally enjoy life.  I/we understand on behalf of myself /ourselves and the Camp Participant, the I/we am/are assuming those risks.

 

3. I/we currently know of no physical or mental condition that would impair the Camp Participant's capability for full participation in Tampa Girl's Basketball Camp as intended or expected [except for_____________________________________ (specify)].

 

4. I/we hereby give permission for the staff of the Tampa Girl's Basketball Camp to administer appropriate medical attention including, but not limited to, first aid, treatment and other services, to the Camp Participant in the event of accident, illness or injury occurring during the Tampa Girl's Basketball Camp.  I/we understand that I/we will be responsible for any and all costs of medical attention and treatment provided to the Camp Participant.  I/we acknowledge that the Camp Participant must have health and accident coverage in effect for the duration on the Tampa Girl's Basketball Camp.  The name of the insurance company and policy number are provided below.

 

5.  On behalf of myself/ourselves and the Camp Participant, Releasor(s) hereby release, waive, discharge and agree not to sue TJ Hoops Inc., The University of Tampa, and/or its officers, directors, servants, agents, employees, instructors, trip and event leaders, assistants and other representatives and, if applicable, the owners or leasees of of premises in which sports and related events and activities are conducted  ("Releasees")  FOR ANY LIABILITY, ACTION, CLAIM, LOSS, COST OR EXPENSE OF ANY KIND ARISING DIRECTLY OR INDIRECTLY FROM ANY AND ALL PERSONAL INJURY AND BODILY INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR TO REAL OR PERSONAL PROPERTY THAT MAY BE SUSTAINED BY THE CAMP PARTICIPANT WHILE INVOLVED IN SPORTS CAMP WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

 

6. I/we further AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage or cost, including court costs and attorney's fees, that they might incur due to the Camp Participant's involvement or participation in the Tampa Girl's Basketball Camp and related events and activities WHETHER CAUSED BY NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

 

7. I/we have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I/we have given up substantial rights by signing it, and sign it freely and voluntary without any inducement.

 

8. I/we agree that this agreement is contractual  in nature and will be governed by the laws of the state of Florida.  In the event that any portion of this agreement is held invalid, I/we agree that the balance shall, notwithstanding, continue in full legal force and effect.

 

9. I/we agree that this Agreement shall be legally binding upon myself/ourselves, my/our heirs, estates, assigns, personal representatives, executors, administrators and next of kin.

 

________________________________________________________________________________________________________________

Insurance Carrier                                                                                                        Policy #

 

Name of Family Physician:____________________________________________________ Phone:________________________________

 

___________________________________________________________                 ______________________________

Parent/Guardian Signature                                                                                          Date

 

___________________________________________________________                 ______________________________

Parent/Guardian Signature                                                                                          Date