Camp Registration Form - Raw Talent Builders Athletics

Registration Form

Below is the registration form for the RTBA camp. Please read carefully, fill out in-full and submit. Thank you!

Name (Participant)(Required)

First Middle Last Suffix

Full name of participant.

DOB

Date of birth of the participant

Age(Required)

Age of participant

Gender(Required)

Male or Female

Grade(Required)

Grade of participant

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current address of participant

Parent/Guardian 1's Name(Required)

First Last

Full name of parent/guardian

Parent/Guardian 1's Phone Number(Required)

Best POC for parent/guardian

Parent/Guardian 1's Email:(Required)

Best email for parent/guardian

Parent/Guardian 2's Name

First Last

Full name of parent/guardian

Parent/Guardian 2's Phone Number

Best POC for parent/guardian

Parent/Guardian 2's Email:

Best email for parent/guardian

Please specify any health concerns, allergies, current/previous medications, or any other concerns that we should be aware of regarding the participant:

Please be as specific as possible.

T-Shirt Size(Required)

Small, Medium, or Large T Shirt - please select

Camp Total:

Price:

2-Day Camp Fee

Credit Card

Please enter payment information here.

Photograph Consent:

Please check this box if you DO NOT wish to have any photos taken of participant during the camp for marketing purposes, website, promotion, etc.

By not checking the box, you agree to the following:

1. Release to use my child's likeness in any photograph, website, online publication, social media, video or other digital media (“Photos”) taken or to be taken on July 19 and 20, during the RTBA Camp in any and all of its publications, including print or web-based publications.

2. I authorize RTBA Camp to copy, edit, enhance, crop or otherwise alter any Photo for use in their publications. I also waive any rights for approval or inspection of any Photos.

3. I understand and agree that all Photos are the property of RTBA Camp, and will not be returned to me.

4. I acknowledge that I am not entitled to any compensation or royalties with respect to the use of the Photos.

5. I agree to release and forever discharge Raw Talent Builders Athletics and its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which I, and anyone claiming on behalf of me, may have or claim to have against Releasee in connection with this Release.

Camp Consent/Release of Liability: Please Read Carefully(Required)

Release of liability:

I/my child or children are voluntarily participating in the aforementioned activity and I/my child or children are participating in the activity entirely at our own risk. I/my child or children are aware of the risks associated with participating in this activity, which may include but are not limited to: physical or psychological injury, pain, suffering, etc. I understand that these injuries or outcomes may arise from the activity, or from conditions at the activity location(s), or all other factors associated with this activity. Nonetheless, I assume all risks both known and unknown to me regarding my child(s) participation in this activity. I agree to hold harmless the host(s), or any other persons directly involved in the activity/camp against any and all claims, suits or legal actions of any kind whatsoever for liability, damages, compensation, or otherwise brought by myself or anyone on my behalf. I further acknowledge that host(s) are not responsible for any accidents/failures. I hereby acknowledge that I have carefully read this waiver and release and fully understand that it is a release of liability.

I agree to and understand these terms.

Name of Parent/Guardian(Required)

First Middle Last

This will act as your digital signature, consenting to the above terms

Date(Required)

Today's date

Registration Form

Raw Talent Builders Athletics

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