This field will be accepted as your legal electronic signature for this form upon it's submission.

ex: 9998887777

ex: TX, OH, NY, FL

ex: 76244

ex: 9998887777

What is the start date of your camp?

Prior to any activity with The Service Providers, I will provide a list of any allergies, medicines, and/or any medical conditions the student may have, to The Service Providers, along with the information needed for any medical emergencies. Also, I will list if The Participant(s) may need and/or carry an EpiPen. If there are no known allergies, please enter "nka".

How did you hear about Kevics Golf Academy?

Is there anything else you'd like us to know about the camper?

Periodically we share stories, pictures, and videos of The Participant(s) and his/her successes. We also feature the students in advertising and marketing materials. I agree to grant to The Service Providers and its authorized representatives permission to record on photography, film and/or video, pictures of participation by The Participant(s). I further agree that any or all the material photographed may be used, in any form, as part of any future social media, publications, brochures, electronic, or other printed materials used to promote Kevics, LLC, and further that such use shall be without payment of fees, royalties, special credit, or other compensation.

In consideration of being allowed to participate in any way in the services provided by Kevics LLC, any golf course, other facilities, and the staff, employees, independent contractors, volunteers, (collectively known as The Service Providers) related events and activities, I acknowledge, appreciate and agree that: 1. The risk of injury from the activities involved in these sport events is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and 2. I knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for participation of The Participant(s); and 3. I willingly agree to comply with the stated instructions and policies and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during the presence or participation of The Participant(s), I will remove The Participant(s) from participation and bring such to the attention of The Service Providers immediately; and 4. I understand that if The Participant(s) is to be a passenger in any form of vehicle while traveling to and/or from or during any of The Service Providers related activities, I assume all liability insurance coverage; and 5. I, for The Participant(s) and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify and hold The Service Providers, and their officers, officials, agents and/or employees, other sport participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event or activity (“Releases”) harmless with respect to any and all injury, disability, death, or loss or damage to person or property, to the fullest extent permitted by law. Do you agree that you have read and you accept the Waiver of Liability?

I understand, agree and acknowledge that some activities may be of a hazardous nature and/or include physical and/or strenuous activity. Understanding this, I state that The Participant(s) has no medical condition or impairment that might inhibit safe and active participation in the services provided. In addition, I understand that The Service Providers do not provide medical insurance coverage for service participants and that any applicable medical insurance must be provided individually by such participants. In the case of injury or medical emergency and in the event participant, or their parent or guardian, cannot respond at the time of the emergency, The Service Providers have permission to seek, administer, or have administered whatever first aid or emergency medical care deemed necessary for The Participant(s)’s welfare, and it is understood that The Participant(s), and not The Service Providers, shall be responsible for any and all charges for such health care services regardless of whether participant’s medical insurance would cover such charges. Do you agree that you have read and you accept the Assumption of Risk?

Virus/Disease/Illness Procedures: Read these procedures with The Participant(s) that will be entering or visiting our facilities. I acknowledge the risk of viruses, diseases, and illnesses being unknowingly present during any activity in which The Participant(s) participates. Wearing a mask is the choice of The Participant(s) unless otherwise required by city, state, or federal laws, statutes, and/or executive orders. Non-compliance with lawful requirements may result in the Service Providers asking The Participant(s) to leave the facility immediately until compliance is rendered. If lawfully required to wear a mask, properly wearing a mask means that it covers the nose and mouth completely. Physical Distancing: The Service Providers may need to get closer than 6 ft to adjust The Participant(s) and/or their equipment to help the learning process. Do you agree that you have read and you accept the Virus & Illness Risk Acknowledgement?

The Service Providers take safety seriously and expect the following rules to be observed by The Participant(s) at all times. Failure to follow these rules may result in the removal from the activity and facility immediately. The Service Providers hold the right to change, update, and implement these and any new policies as it sees fit for the safety of The Participant(s) and The Service Providers. RULES: 1) Be respectful of everything and everyone. 2) No talking when The Service Providers are talking. 3) No running, skipping, hopping across the putting greens. 4) Students must stay within the hitting zone boundaries and may only enter and exit the zone through the back end, never through the sides or the front of the area. 5) When not hitting a shot in the designated hitting zone, the student is to hold the club upside down by the club head like holding a cane. 6) No swinging of clubs. 7) No touching of other students, keep your hands to yourself. This includes no punching or hitting other students/coaches, no damaging of the property. 8) No yelling or screaming as you need to be respectful of the other patrons at the facility. Do you agree that you have read and you accept the Safety Procedures & Rules?

Full Refunds are given to the card on file if: 1) Kevics Golf Academy needs to cancel the camp, 2) you cancel before the 24 hours prior to the start of camp. Partial (80%) Refunds are given to the card on file if: 1) you late cancel, meaning you canceled within the 24 hours prior to the start of camp. No Refunds are given: 1) for no call no shows, 2) for missed days, 3) when the camper is asked to leave camp due to violating the safety policy, 4) when the camper is asked to leave camp due to lack of respect, behavioral matters, and/or an attitude that is inconsistent with our junior academy's expectations. If the camp is scheduled outdoors and there is inclement weather, we will first try to move the camp to our indoor facility in Keller, TX located at:133 Sports Pkwy, Ste D, Keller, TX 76248. If that space is occupied, we will try to extend the camp an extra day. If we can't extend the camp because of continued inclement weather, then the camper will be refunded for the days not completed. If the entire week has inclement weather and we don't get started, we will cancel the camp and refund the entire camp.