Mustang Basketball Camp Release of Liability/Pictures/Covid/and Medical Form
  WARNING: THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS, READ IT CAREFULLY. 
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Camper's Last Name
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Camper's First Name
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ANY MEDICAL CONDITION? (If Yes, please note details, If No, please enter None)
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1. Emergency Contact (First and Last Name) *
1. Relationship to Camper (Ex. Parent) *
1. Cell Phone Number (###) ###-####
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2.. Emergency Contact (First and Last Name)
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2. Relationship to Camper (Ex. Grandpa)
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2. Cell Phone Number (###) ###-#### *
MEDICAL WAIVER
We the undersigned on this Google Form, hereby certify that I (we) am (are) the parent(s) or legal guardian of the camper. I hereby give my permission for the staff of the Mustang Basketball Camp to seek during the period of the camps appropriate medical attention and treatment.  do hereby authorize in the event of an injury, accident, or illness, Mustang Basketball Camps and its coaches, team representatives, directors, officers, agents, and assignees to seek and obtain care and medical treatment as shall be necessary under the circumstances.
I/we hereby authorize and direct the above named to consent to any x-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital care which is deemed advisable and rendered under the general or special supervision of any member of the medical staff and emergency room staff licensed under the provisions of the Medical Practice Act, of a dentist licensed under the provisions of the Dental Practice Act, and on the staff of any general hospital holding a current license to operate a hospital from the State Department of Public Health or its equivalent. This authorization is effective whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, or elsewhere. It is understood that effort shall be made to contact the undersigned before rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached. I also agree that this authorization to treat shall be valid in any state where such treatment is rendered. I also agree that if English is not my first language that I have sought out someone to translate this form to me and agree that by my signature that I have read and understood the document.
I/We the undersigned, for ourselves, our heirs, executors and administrators, waive, release, and forever discharge the Mustang Camp and its staff, officers, agents, employees, representatives, successors, and assign from any and all liability claims, demands, actions, and causes of actions whatsoever arising out of or related to any loss, personal injury, or property damage that may be sustained or occur during participation in camp activities of while at camp. All campers must have their own medical coverage.   Campers will not be allowed to play unless the following information is submitted and the form signed by the parent(s) or guardian of the camper.
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  WARNING: THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS, READ IT CAREFULLY! 
Every participant must read and understand this Acknowledgment, Waiver and Release of Liability prior to participating in athletic activities. Every participant is advised to consult with their physician before engaging in the athletic activities. The undersigned (the “Participant”) hereby enters into this Agreement with and for the benefit of Mustang Basketball Camp, Mustang Sports Camps, Inc., its directors, officers, employees, volunteers, coaches, officials, trainers, business operators, agents and site property owners (the “Company”). 
1. “Athletic activities” shall include, but not be limited to, contact and non-contact sports, personal training instruction and activities, use of facilities, and fitness and exercise programs and services provided to the Participant by the Company. 
2. The Participant acknowledges and understands that there are inherent and significant risks associated with participation in athletic activities, including (but not limited to) the potential for serious personal injury caused by any event or any condition of the facilities or equipment provided by the Company, and health risks such as light-headedness, fainting, increased or decreased blood pressure, chest discomfort, muscle cramps, broken bones, strains, sprains, bruises, concussion, hypothermia, abnormal heart rate, soreness, nausea, heart attack, stroke and possibly death. The Participant understands that such risks are relative to Participant’s level of fitness and health (physical, mental and emotional), and to the awareness, care and skill which the Participant demonstrates while participating in the athletic activities. 
3. The Participant hereby accepts and assumes all responsibility for all risks and possibilities of personal injury, death, property damage or loss resulting from his/her participation in the athletic activities, including accidents or injuries that occur within the facilities (e.g. in the locker rooms, dressing rooms, showers, restrooms, and other areas). The facilities and programs offered by the Company have been designed and established to provide the optimum level of beneficial exercise and enjoyment without compromising the health and safety of those who utilize the facilities or participate in the athletic activities. Due to the nature of the athletic activities and the equipment that is often an integral part of such activities, there is an inherent risk of injury. This results in a practical limitation being placed on the Company in its effort to prevent injuries to participants, whether actively participating in athletic activities, utilizing the equipment or taking advantage of the other facilities. The Participant freely accepts these risks and agrees to the terms of this Waiver and Release, even if the Company is found to be negligent or in breach of any duty of care or any obligation to the Participant with respect to his/her participation in athletic activities. 
4. The Participant agrees to at all times utilize the equipment and the facilities in a proper manner so that the inherent risk that exists under the control of the Company, as well as those risks outside the control of the Company or partially within the control of the Participant are minimized by the Participant’s thoughtful and cautious use of both the equipment and the facilities. 
5. The Participant acknowledges his/her obligation to immediately inform an employee or other representative of the Company immediately upon feeling any pain, discomfort, fatigue or other symptoms suffered by the Participant during or immediately after participation in any athletic activity. The Participant understands that s/he may stop participation at any time, and may be requested to do so by any employee or representative of the Company who observes symptoms of distress or abnormal response from the Participant. 
6. The undersigned Participant, for him/herself and his/her heirs, next of kin, executors, administrators and assigns (collectively, the “Releasing Parties”), does hereby agree: 
      (a) to waive all claims that the Releasing Parties or any of them may have in future against the Company, its directors, officers, employees, agents, insurers and representatives (collectively, the “Released Parties”); 
      (b) to release and forever discharge the Released Parties from all liability for personal injury, death, property damage or loss resulting from the Participant’s participation in athletic activities due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake or error of judgment on the part of the Company; and 
     (c) to be liable for and to hold harmless and indemnify the Released Parties from all actions, proceedings, claims, damages, costs, demands, including hospital costs, court costs and attorneys fees, and liabilities of whatsoever nature or kind arising out of or in any way connected with the Participant’s participation in athletic activities. 
7. This Agreement shall be governed by and construed in accordance with the laws of the State of California, and any legal actions, claims or demands shall be handled in a court of competent jurisdiction within such State. 
8. The Participant understands that this document is binding on him/herself and his/her heirs, next of kin, executors, administrators and assigns.
 I hereby certify that I am at least 18 years of age, or my parent or guardian has signed below, that I am suffering under no legal disabilities, and that I (or my parent or guardian) have read this document carefully, understand each term and provision in its entirety, have agreed to the terms freely and voluntarily. Having read the 
foregoing, I (or my parent or guardian) knowingly acknowledge my understanding of the risks set forth herein and knowingly agree to accept full responsibility for my own exposure to such risks. I also agree that if English is not my first language that I have sought out someone to translate this form to me and agree that by my signature that I have read and understood the document.

   
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Photo Release

I give permission and consent for my child (the participant player’s name stated above in this form) to allow photographs to be taken of his basketball, team bonding activities. I further give permission and consent that any such photographs may be published and used by Mustang Basketball Camp( the Company), to illustrate and promote the basketball experience, and its basketball programs. By signing below, you authorize Mustang Basketball Camp (the Company) and its official representatives to use, without obligation, photos or videos of you, your child for any and all publicity, publications, and advertising purposes for Mustang Basketball Camp, (the Company) may designate.

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Covid 19
Due to the COVID-19 virus or other potential infectious diseases, I understand and acknowledge, the risk of infection from the COVID-19 virus, or others potential infectious diseases, cannot be eliminated at this time, and that my son/daughter may be exposed as a result. I also understand and acknowledge that in participating in this camps/sport/athletic event or activity, my son/daughter will increase his/her interaction with other athletes/players, coaches, and the corresponding risk of contact and infection, and that this may include functions involving students and facilities other than the Mustang Basketball Camp (the Company), operating under potentially a different reopening plan, further increasing the risk of exposure of my son/daughter. Finally, I understand, acknowledge and agree that despite reasonable care and steps by the Mustang Basketball Camp (the Company), that the virus presents serious challenges to prevention and control, and reasonable efforts by the Mustang Basketball Camp (the Company), that does not assure that my son/daughter may not be infected, and that the infection may not be brought home. Despite all the above I am freely and voluntarily signing this “Voluntary Sports/Athletic Event or Activity, Informed Consent and Liability release, Acknowledgment and Assumption of Risk” form to enable and authorize my son/daughter to participate and releasing and discharging the Mustang Basketball Camp (the Company), and its/their governing board, officers, agents, employees and/or volunteers from any liability for my son/daughter becoming infected in his/her participation in the event or activity  
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Electronic Signature Agreement
By checking the "I Accept" box, you are signing this Mustang Basketball Camp document electronically. You agree your electronic signature is the legal equivalent of your manual signature on this document. By selecting "I Accept" you consent to be legally bound by this document’s terms and conditions.
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Required
Parent or Guardian Signature
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Electronic Signature Agreement
By checking the "I Accept" box, you are signing this Mustang Basketball Camp document electronically. You agree your electronic signature is the legal equivalent of your manual signature on this document. By selecting "I Accept" you consent to be legally bound by this document’s terms and conditions.
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Parent or Guardian Signature
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