Evan Michael Chambers Love Foundation Camp
Waiver and Consent Form
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Camper's Name *
Camper's Age *
I, the undersigned, hereby certify that I am the parent or legal guardian of the camper named in this registration.  I hereby give permission for the Camp staff to seek during the period of the Camp, appropriate medical attention for my child, for the medical attention to be given to my child, and for my child to receive the medical attention in the event of accident, injury or illness. I will be responsible for any and all costs of medical attention and treatment.  I, the undersigned, understand that Baseball (sport) is an active, physical sport and that injuries can often occur during participation at Camp.  I also understand that there will be more campers than staff at the Camp, and that my child cannot receive individualized attention and individualized supervision at all times. I hereby acknowledge that my child is physically fit and mentally capable of participating in practices, games, and all camp activities.  I waive, release, and forever discharge the Evan Michael Chambers Love Foundation, G Sports Management and Lakeland City Baseball and the aforementioned staffs, officers, agents, employees, representatives, successors, and assigns from any and all liability claims, demands, actions, and cause of action whatsoever arising out of or related to any loss, personal injury, or property damage that may be sustained or occur during the participation in camp activities or while at Camp. I give permission for the Evan Michael Chambers Love Foundation, G Sports Management and Lakeland City Baseball to take photographs of my child while engaged in Camp activities for the sole purpose of advertising and publicity, and I understand that my child’s identity will remain anonymous in conjunction with any photograph used in marketing.  My signature below indicates that I have provided true information and have read, understand and agree to all statements on this entire form and on any other form required by the Camp. By entering my name below, I consent to these terms and my signature being captured electronically via text in this form. *
General Waiver Acceptance
Required
COVID-19 Waiver and Liability Release - In consideration of being allowed to participate in any way in the 2021 Evan Michael Chambers Love Foundation Baseball Camp on February 6th, 2021, the undersigned acknowledges, appreciates, and agrees that: 1. The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) from the activities involved in this program are significant, potentially life-threatening, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and,  2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASOR or others, and assume full responsibility for my child’s participation; and,  3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest team Coach and League official immediately; and,  4. I acknowledge that I am aware that there are risks to me and my child(ren) of exposure to directly or indirectly arising out of, contributed to, by, or resulting from:• An outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome corona-virus 2 (SARS-CoV-2)”, which is responsible for Corona-virus Disease (COVID-19) and/or any mutation or variation thereof;  5. I acknowledge and will follow the City of Lakeland Parks and Recreation COVID-19 Guidelines to the fullest extent;  6. In consideration of having the opportunity to participate as either a team member or competitor at location, and in acknowledging that I am aware of and willing to assume the risks associated with this activity, I hereby voluntarily agree to waive, hold harmless and indemnify Lakeland City Baseball Leagues Inc, it’s Board Members and volunteers, as well as the the Evan Michael Chambers Love Foundation, G Sports Management, City of Lakeland, its trustees, agents, volunteers and employees from any and all claims, demands, damages and causes of action of any nature whatsoever arising out of ordinary negligence which I, my heirs, my assigns or successors may have against them for, on account of, or by reason of my participation in the above activities. I indicate my agreement to this and hold harmless elective noted below.
COVID 19 - General Waiver Acceptance
Enter Parent/Guardian's Name.  (Electronic Signature as indicated in terms) *
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