Freeman Consulting Presents 1st Annual Elite Football Camp With Special Guest Lavelle Hawkins of The New

England Patriots
When:
July 22, 2013 9:00am - 4:00pm Check-In: 8:30am

Whos Invited:
Youth Ages 6-17 Registration Form & Waiver Js Coffee House & Grill 2601 Oakdale Road, Suite Q Modesto, CA (209-566-9168) Fax: 209-846-9309 https://www.facebook.com/freemanelite.camp COST: $75 (pre-registered) $100( day of camp)

Where:
Modesto Junior College Football Field 435 College Ave Modesto, CA

Come on July 22nd wearing workout attire, tennis shoes or cleats (no pads). You will be contacted

via email or mail to confirm your attendance.

Childs name:_________________________________________________________________________ Age and Position:_______________________________________________________________________ Address:______________________________________________________________________________ Phone Number:________________________________________________________________________ Email Address:_________________________________________________________________________ Emergency Contact Name & Number :______________________________________________________ Allergies:_____________________________________________________________________________ Current Medication:____________________________________________________________________ Pertinent Medical History:_______________________________________________________________ Family Doctor:_________________________________________________________________________ Phone: (____)______________________________________ne____________________________________ Insurance Co.:_________________________________________________________________________ Policy Holder:__________________________________________________________________________ Policy Number:________________________________________________________________________ T-Shirt Size:___________________________________________________________________________

Incomplete applications will NOT be accepted!!!!!

Questions or concerns, please contact Jeneya at (209)541-7080 or via email at jeneyafreemanpromo@gmail.com

Participants Name: _____________________________________________________________________________ Freeman Consulting 1st Annual Elite Football Camp 2013 June 29, 2013 Waiver of Liability, Assumption of Risk, and Indemnity Agreement
Waiver: In consideration for being permitted to participate in any way in Freeman Consulting 1st Annual Elite Football Camp 2013 , I, for myself, my heirs, personal representatives and assigns (including, but not limited to the participant in the camp listed on t he application) (collectively Releasing Parties), do hereby release, waive, discharge and covenant not to sue Freeman Consulting 1st Annual Elite Football Camp 2013, its owners and their respective partners, owners, officers, employees, directors, contracto rs, assigns and agents (collectively st Freeman Consulting 1 Annual Elite Football Camp 2013 from and for any and all claims, liabilities, cost, fees, action and causes of action of every nature, character and description, known and unknown, including, but not limited to, all those arising out of or in any way related st to the negligence of Freeman Consulting 1 Annual Elite Football Camp 2013 , any individuals presence at the camp (as a participant or otherwise), any personal injury, any accidents or illn esses (including death), and or any property loss (collectively, the Claims). Releasing parties expressly waive the Provisions of section 1542 of the California Civil Code, which provides that A general release d oes not extend to claims which the creditor does nor know or suspect or exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor. The signatory below represents and warrants that he or she owns and /or has the authority to release the Claims released herein and to bind each of the Releasing Parties as provided in this Waiver of Liability Assumption of Risk and Indemnity Agreement, that none of the Claims have been assigned or transferred, and that this document cont ains the entire agreement of the parties. _____________________________________________________________________________________________________________________ Signature of Parent of Minor (on behalf of all Releasing Parties) Date Assumption of Risk: Participation in Freeman Consulting 1st Annual Elite Football Camp 2013carries with it certain inherent risk that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another and from one individual to another, but the risk include, but are not limited to 1) minor injuries such as scratches, bruises and sprains to 2) major in juries such as eye injury or loss of sight, joint or back injuries, heart attacks and concussions and/or 3) catastrophic injuries including paralysis and death. Releasing parties acknowledge that they have read the previous paragraphs and know, understand, and appreciate these and othe r risks that are inherent in The Freeman Consulting 1st Annual Elite Football Camp 2013. Releasing Parties hereby assert that their participation is voluntary and Releasing Parties expressly agree that they knowingly assume all such risks. Indemnification and Hold Harmless: Releasing Parties also agree to DEFEND, INDEMNIFY AND HOLD HARMLESS Freeman Consulting 1st Annual Elite Football Camp 2013 from and against any and all claims, actions, causes of action suits, procedures, costs, expenses, damages and liabilities, including attorneys fees , that arise out of or are in any way related to the camp or any of the Releasing Parties participation in or presence at Freeman Consulting 1st Annual Elite Football Camp 2013. Releasing Parties further expressly agree that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal for ce and effect. Acknowledgement and understanding: Releasing Parties acknowledge and expressly agree that they have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that they are giving up substantial r ights, including rights to sue. Releasing Parties acknowledge that they are signing the agreement freely and voluntarily, and intend the signature below to be a completed and unconditional release of all liability to the greatest extent allowed by law. _____________________________________________________________________________________________________________________ Signature of Parent of Minor (on behalf of all Releasing Parties) Date RELEASE AUTHORIZATION FOR EMERGENCY TREATMENT I understand that I am required to maintain and carry accident medical insurance coverage for the child listed on this application and I verify that the coverage information in the application is accurate and true. In the case of an emergency and if I cannot be reached , I authorize the staff of Freeman Consulting 1st Annual Elite Football Camp 2013 to obtain whatever medical treatment he/she deems necessary for the welfare of my child listed on this application. I further understand that I will be financially responsible for all charges a nd fees incurred in the rendering of said emergency treatment, regardless of whether or not my medical insurance would cover such charges and fees. I am the parent/guardian of the minor ___________________________________________________________ and I am signing this Release on behalf of said minor. _____________________________________________________________________________________________________________________ Parent/Guardian Signature Date