CAMPER REGISTRATION

Name:______________________________________
Home Address:_______________________________
City, State:__________________ Zip:____________
SSN:_________________ D.O.B. ____/____/______
Participants (Cell) Phone:_______________________
Age: ________ Height: ________ Weight: _______
School:_____________________________________
Grade (Fall 15):_____ Year of HS Graduation:______
Roommate Preference:_______________________
Position O: QB RB WR TE OL
Position D: DL LB DB
Cost:
Dorm Camper - $215 Turner Hall, $230 Rendezvous
Holt Camper - $175
Day Camper - $125
INSURANCE INFORMATION:
Policy Holders Name:_________________________
Medical insurance company:___________________
Policy Number:_________________
Date of last tetanus immunization:_____________
Please list any medical conditions or allergies that the
camper might have of which the medical authorities
should be aware in order to administer medical
treatment.
_____________________________________________
_____________________________________________
Emergency Contact:____________________________
Relation to Participant:_________________________
Phone:_______________________________________

ASSUMPTION OF RISK, RELEASE, INDEMNIFICATION AND COVENANT

NOT TO SUE
1. By accepting this agreement and having your child participate in
Idaho State Universitys Football Camp (Football Camp), you
acknowledge that there is a risk of property damage or loss, as well as
a risk of bodily injury, including but not limited to concussion; serious
back and spinal injuries; complete or partial paralysis; brain damage;
injury to bones, joints, ligaments, muscles, tendons; injury to or
impairment of general health and well-being; and even death.
2. Your agreement indicates that you understand that your child
should not participate in Football Camp if:
Your child is currently under the care of a physician for an injury or
illness that would prevent safe participation;
Your child is currently being treated for or recovering from an
orthopedic injury that would prevent safe participation;
Your child has a history of fainting or other problems due
strenuous exercise; or
Your child is not in good health or has some other reason he or she
should not participate in strenuous physical exercise.
3. CONSENT:
By indicating your acceptance of this agreement, you hereby give
permission for Football Camp employees, representatives, volunteers
and agents (Football Camp Staff) to obtain emergency medical
treatment for your child in the event of accident or illness while at
Football Camp. This includes transportation to and exchange of
medical information with a medical facility.
By indicating your acceptance of this agreement, you hereby give
consent to have your child be photographed or videotaped during
Football Camp activities, and you agree that the images so obtained
may be used for educational and public relations purposes by Idaho
State University.
4. INSURANCE:
By indicating your acceptance to this agreement, you hereby
acknowledge that Idaho State University will not provide any type of
insurance coverage for you or your minor child. You agree that you are
be responsible for all costs associated with any injury, illness, damage,
expense, claim, or loss that occurs as a result of your childs
participation in Football Camp. You also certify that you have health
insurance which provides adequate coverage for injuries or illness your
child may sustain, as well as automobile insurance for travel to and
from Football Camp.
5. RELEASE:
To the fullest extent permitted by law, and in consideration for your child being
allowed to participate in Football Camp, you, on behalf of yourself, your minor
child, heirs, representatives, executors, administrators, and assigns (the
Releasing Parties) hereby agree to hold harmless, release, and covenant not to
sue the State of Idaho, its State Board of Education, Idaho State University, and
their respective officers, employees, volunteers, and agents (Released Parties)
for any negligently caused injuries or losses arising from or related to Football
Camp. You further agree to defend and indemnify the Released Parties and each
of them from any claims, demands, actions, damages, costs, fees, or expenses
arising out of losses suffered by or caused by your minor child that are brought
now or in the future by the Releasing Parties or any of them, or by a third party.

6. REQUIRED EQUIPMENT AND HELMET WARNING AND CARE:

ALL protective equipment designated for competition, including
mouthpieces, tail pads, hip pads, helmets, etc. must be brought to
Football Camp. Anyone not properly dressed will be excused until
proper equipment is obtained. Equipment problems must be
reported immediately to the Football Camp Staff.
WARNING: NO HELMET CAN PREVENT ALL HEAD OR NECK INJURIES
RECEIVED WHILE PARTICIPATING IN FOOTBALL CAMP.
Helmets must not be used to butt, ram, or spear an opposing player.
This is in violation of the Football Camp rules and such use can result
in severe head, brain, or neck injury, paralysis, or death. There is a
risk that these injuries may also occur as a result of accidental
contact without intent to butt, ram or spear.
A HELMET IS NOT A WEAPON; IT IS FOR PROTECTION.
Each time a helmet is used, the following 5-step check should be
performed:
Inspect helmet for obvious cracks, loose parts, or damaged cells or
pads. Does it hold air?
Check the crown by pulling down on the helmet to make sure it
doesn't slide over the eyes.
Grasp face mask and turn helmet side-to-side. Be sure skin wrinkles
and that helmet doesn't just spin.
Check that jaw pads touch cheeks and that ear holes align with ears.
Check that the chinstrap is centered and snug, and the snaps hold
well.
7. BEHAVIOR:
The mission of the Football Camp is to provide exceptional facilities,
services, programs and experiences that engage, inspire and enrich
lives. The following rules must be observed:
Disruptive or dangerous behavior that jeopardizes the safety and
well-being of others will not be allowed. Participants will be given a
warning and will be dismissed from Football Camp if problems
cannot be corrected.
The use or possession of alcohol, tobacco, drugs, weapons, or any
controlled substances by any participant will result in dismissal from
Football Camp.
Criminal behavior, including the unauthorized use of, theft of, or
damage to the property of ISU, any other participant, or Football
Camp Staff will result in dismissal from Football Camp.
Parents/guardians of dismissed participants will not be reimbursed
the Football Camp tuition or fees.
I, as parent/guardian of the participating minor child, represent and
warrant that 1) I have read the terms and agree to them, 2) I have
the legal right to execute this document on behalf of the minor, 3)
this document, once executed by me, is fully enforceable in
accordance with its terms, and 4) I will indemnify the Released
Parties in the event this representation is not accurate.
Athlete Signature:____________________________________
Parent/Guardian Signature:____________________________