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SPORTS, GAMES, ARTS, AND ENTERTAINMENT
Camps & Clinics
camps & clinics
Gridiron Workshop 2020
Registration for the 2020 Gridiron Workshop 3-day Offensive and Defensive Line Camp. Dates are July 24-26th from 4-6pm. Cost is $120.00.
# of years playing tackle football
Parent cell #
Parent email address
Player Birth date
District of Columbia
Emegency Contact Person
Alternate Emergency Contact Person
Past Injuries you would want health care provider to konw about?
Medications you would want health care provider to know about?
Medical Release/Waiver of Liability Medical Release
I give my permission for myself and/or as parent and/or legal guardian to SportzSnap Inc. and D1 Prime Inc including but not limited to its coaches, employees, representatives, witnesses, managers, members, independent contractors, sub-contractors, and/or agents (hereinafter referred to as "collective parties ") to act on my or my Child's behalf in an emergency dealing with the health and welfare of my Child and to obtain emergency treatment for him/her by a licensed physician and/or medical institution and their official representatives in the event that I cannot be reached. Waiver of Liability I hereby give permission for myself and/or my Child, as his/her parent or legal guardian, to participate in all indoor and outdoor athletic activities, gaming events, and social activities and gatherings, on SportzSnap Inc. and D1 Prime Inc. managed/leased properties, including use of SportzSnap and D1 Prime owned equipment and supplies, including, but not limited to, athletic activities, competitive games, tournaments, social events, non-athletic competition, meetings, gatherings, and practices (collectively, "Activities "). I affirm that I and/or my Child is/are physically and mentally fit to participate in SportzSnap and D1 Prime activities. I acknowledge that I am fully aware of the potential risks and hazards of/for myself and/or my Child participating in any and all Activities, including, but not limited to, minor injuries such as scratches, bruises, and sprains; injury due to allergic reactions or contagions, bacterial and viral infections, major injuries such as broken bones, joint and back injuries, heart attacks, and concussions; and catastrophic injuries such as paralysis and death, and mental catastrophes leading to mental healthcare or suicide, and I hereby elect to allow myself and/or my Child to voluntarily participate in said activity with full knowledge that said activity may be hazardous to myself and/or my Child and mine or my Child's property. In consideration of the foregoing, I hereby voluntarily agree for myself, my Child, my family, heirs, executors and administrators, to assume full responsibility for any and all risks of loss, property damage, or personal injury, including, but not limited to, viruses, bacterial infections or disease, or other diseases, illness, psychological trauma, and/or death that may be sustained by myself or my Child as a result of participation in any and all Activities at/on/in SportzSnap Inc. and D1 Prime Inc managed/leased properties, facilities, fields, or as a result of use of SportzSnap owned equipment and supplies, or due to the negligence of other members, participants, and coaches, trainers, and agents, including their negligent use and/or malfunction of their own training tools, supplies, and/or equipment, whether caused by the negligence of Released Parties or otherwise. I further agree that SportzSnap Inc. and D1 Prime Inc. owe no obligation of care to myself and/or my child and shall not be liable for consequences that may otherwise be considered negligent. In consideration for receiving permission to participate in Activities, I hereby release, waive, discharge and covenant not to sue Sportzsnap Inc. and/or D1 Prime Inc., both Illinois corporations, and all of their officers, directors, members, managers, coaches, agents, representatives, contractors, subsidiaries, sponsors and affiliates (hereinafter collectively referred to as " Released Parties ") from any and all costs, liabilities, claims, demands, actions, expenses and fees whatsoever in any way arising out of or related to any loss, damage or injury, including death, that may be sustained by myself and/or my Child, or any of the property belonging to me or my Child, whether caused by the negligence of the Released Parties, or otherwise, while participating in Activities, or while in, on or upon the premises where the activity is being conducted. I further agree to indemnify and hold harmless the Released Parties from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my participation in said activity, whether caused by negligence of Released Parties or otherwise, that I or my child might now have or may acquire in the future. It is my express intent that this waiver of liability and indemnification shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a release, waiver, discharge, indemnification and covenant not to sue the above-named Released Parties. I hereby further agree that this release, waiver of liability and indemnification shall be construed in accordance with the laws of the State of Illinois. In signing this release, waiver and indemnification, I acknowledge and represent that I have read the foregoing, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made. I am at least (18) years of age and fully competent; and I execute this release on behalf of myself and my Child for full, adequate and complete consideration fully intending to be bound by same.
Credit Card Information
Name on Card
Card Exp Date (mm/yy)
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