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Jordan McLaughlin’s

3rd Annual Basketball Camp

July 7th - 9th 
10am - 1pm
Etiwanda High School

Camper's Birthday
Month
Day
Year
CAMPER'S SHIRT SIZE

RELEASE OF LIABILITY & ASSUMPTION OF RISK WAIVER


I/We hereby acknowledge that I/we are fully aware of the inherent risks involved in the sport of basketball and in participation with Prodigy Athletic events. I/we voluntarily agree to allow our student athlete to participate, fully understanding these risks, which include but are not limited to, the possibility of injury or death.

I/We agree to abide by all rules, regulations, and protocols—spoken or written—set forth by Prodigy Athletic and its staff, both on and off the court, for the entire duration of the athlete’s participation.


GOOD HEALTH CERTIFICATION

I/We affirm that the student athlete:

• Is in good physical condition

• Does not suffer from any known heart conditions

• Is capable of handling the physical contact associated with basketball


INJURY & EMERGENCY MEDICAL CARE

In the event of injury, a certified athletic trainer or qualified staff member will provide immediate examination and/or treatment. If I/we cannot be reached, I/we authorize Prodigy Athletic to contact the emergency contact listed and/or transport the athlete to the nearest medical facility by car or ambulance.


WAIVER & RELEASE (CED SECTION 11710)

I/We hereby:

• Assume full responsibility and risk for any injuries sustained

• Release, waive, and discharge Prodigy Athletic, its organizers, administrators, school partners, volunteers, coaches, and employees from any and all liability (past, present, or future) associated with the student athlete’s participation

JMAC CAMP FEE PAYMENT
$160

Must Pay Camp Fee to Reserve a Spot

Specify which food allergy, if not applicable please write N/A

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