July 2-6, 2012
2012 July 4TH Week Celebration
:: July 1-6 SCHEDULE OF EVENTS
Dear Berkeley Hall Membership, We’ve planned a full week of activities for the entire family at the 4th Annual Signature 4th of July Week Celebration. In addition to a stunning fireworks display on Wednesday, July 4th, we are planning several complimentary events for the entire family. Be sure to sign up for one or all of the golf events & clinics, laser tag at the Fazio, member mingling with summer brew & wine sampling, family pool parties, tennis clinics and a 5K Fun Run/Walk for both Adults and Children alike. We are pleased that you are interested in participating in this celebration and hope the events scheduled will be enjoyable and will create an atmosphere of friendly competition and fellowship. Please refer to this booklet for the itinerary and general information on each event. All reservations must be secured through Concierge Services. If there is anything we can assist you with, please do not hesitate to ask or call (843)815-8494. We look forward to hosting this very special signature event for every member of Berkeley Hall.
Regards,
Adrian Morris General Manager/Chief Operating Officer
Sunday, July 1st 6-8pm
Sunday Pasta Night
Come and create your own Italian pasta dish, then have it prepared by your own Chef. Design your dish with a selection of ingredients, summer vegetables, homemade sauces and several pastas along with salad and desserts. A great family night for all ages. Reservations: Tap Room, 843.815.8428 Location:
Mixed Grille
Price:
$15.95++ adults, $8.95++ children
Monday, July 2nd 9-11am
Guided Kayak Tour
Our 2-hour kayak nature tour offers both a great introduction to kayaking and an educational nature tour on one of the most pristine rivers in South Carolina. A trained interpretive naturalist guide will lead your journey up the Okatie River. No experience necessary and chilled bottled waters are included. Reservations: Concierge Services, 843.815.8494 Location:
Meet at the River Park Dock
Price:
$25.00 per person
Monday, July 2nd
(continued)
9:30-3pm July 4th Week ~ Special Kids Day Camp
SOL
D OU
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Two-day July 4th Week Kids Camp for ages (6-10) years. Events include summer pottery, tennis, golf, swimming and a special Slip-n-Dip slide at the Spa & Fitness Center. Lunch and snacks will be provided throughout the day. Be prepared to be out in the summer heat, cooling off in the swimming pool and simply having a blast by enjoying all of the amenities that Berkeley Hall has to offer. Children, grandchildren & friends more than welcome. Note: Children must be able to swim well to participate in Berkeley Hall Day Camp. Reservations: Concierge Services, 843.815.8494 Location:
Ladies Locker Room, Lounge
Price:
$50.00 per child, per day
10-11:30am Complimentary Tennis Clinic ~ Adults & Children Come and enjoy an hour and half of tennis, beginning at 10:00 am. The clinic will include active drill situations based on the player’s levels in a fun environment. You will hit plenty of balls and enjoy time with fellow members and guests. There will be supervised play based on the skill levels. Come on out, we look forward to seeing you on the courts. Instruction divided between Adult and Children. Reservations: Spa & Fitness Center, 843.815.8985 Location:
Spa & Fitness Center
Price: Complimentary
Cruise Times: 4pm & 6pm Guided Pontoon Boat Cruises of the Scenic Okatie River Take a relaxing guided boat cruise up the Okatie River and enjoy the panoramic views of the marshes. From the cacophony of wildlife abounds from snapping shrimp to the flights of the marsh wren to the playful dolphins, all can be viewed during this cruise. Reservations: Concierge Services, 843.815.8494 Location:
Meet at the River Park, Dock
Price:
$25.00 per person, includes Cooler of Sodas and Waters
$15.00 per person, children 12 and under
Monday, July 2nd
(continued)
NEW
!
6pm
Goofy Golf Games, Mobile Laser Tag & an Old Fashioned Cookout at the Learning Center
Casual summer evening at the Learning Center. Several Goofy Golf Stations will be set up through the Learning Center to test your game to win a variety of prizes and challenges. ~ Hit to the Floating Pool in the Pond, 3-Hole Putting Challenge, Longest Drive Testing ~ Chef Tom will have an old-fashioned cookout and the Fazio Bar will be open with chilled libations and seasonal cocktail specials. Test your skills with your family while playing Mobile Laser Tag complete with inflatable buoys and obstacles while playing “capture the flag� team game. (Ages 8 & Up)
Old Fashioned Cookout Menu Cilantro Pico de Gallo & Queso Fresco, Tortilla Chips Chilled Salads, Tossed Garden Greens, Ranch or Balsamic Dressing Broccoli & Carrot, Macaroni & Caramelized Ham
Off the Flaming Grill: Flame Grilled Hamburger, Hot Dogs, Chicken Breast and Veggie Burgers with appropriate trimmings Assorted Fruits, Red, White & Blue Cupcakes, Rice Krispy Treats Reservations: Concierge Services, 843.815.8494 Location: Fazio, Learning Center *Back up in the Clubhouse Price: $15.95++ adults, $8.95++ children (ages 4-11)
Tuesday, July 3rd 9:30-3pm July 4th Week ~ Special Kids Day Camp
SOL
D OU
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Two-day July 4th Week Kids Camp for ages (6-10) years. Events include summer pottery, tennis, golf, swimming and a special Slip-n-Dip slide at the Spa & Fitness Center. Lunch and snacks will be provided throughout the day. Be prepared to be out in the summer heat, cooling off in the swimming pool and simply having a blast by enjoying all of the amenities that Berkeley Hall has to offer. Children, grandchildren & friends more than welcome. Note: Children must be able to swim well to participate in Berkeley Hall Day Camp. Reservations: Concierge Services, 843.815.8494 Location:
Ladies Locker Room, Lounge
Price:
$50.00 per child, per day
Cruise Times: 10am, 4pm, & 6pm Guided Pontoon Boat Cruises of the Scenic Okatie River Take a relaxing guided boat cruise up the Okatie River and enjoy the panoramic views of the marshes. From the cacophony of wildlife abounds from snapping shrimp to the flights of the marsh wren to the playful dolphins, all can be viewed during this cruise. Reservations: Concierge Services, 843.815.8494 Location:
Meet at the River Park, Dock
Price:
$25.00 per person, includes Cooler of Sodas and Waters $15.00 per person, children 12 and under
10-11am
Complimentary Adult Golf Clinic, Learning Center
Complimentary Clinics for adults will include swing instruction, exciting prize challenges, and valuable information to better your game. Let our experienced golf professionals enhance your golfing experience with great instruction and drills to better your game this summer. Reservations: Concierge Services, 843.815.8494 Note: Please identify Adult participant Location: Meet at the Learning Center Practice Tee Price:
Complimentary
Tuesday, July 3rd (continued) 11am
Cold Blood Adventures Reptile Show
Very special show to see rare and rescued reptiles. Brian Nettles will share his current collection of rescued and very friendly reptiles while providing education about each one, their habitats, feeding, mating and day to day life. Come by and see the show. Limited to 25 children. Reservations: Concierge Services, 843.815.8494 Location:
Meet in the Berkeley Room
Price: Complimentary Note:
An adult must accompany a child and/or siblings
1pm
Complimentary Children’s Golf Clinic, Learning Center
Complimentary Clinics for children will include simple swing instruction, exciting prize challenges, and valuable information to better your game. Let our experienced golf professionals enhance your golfing experience with great instruction and drills to better your game this summer. Reservations:
Concierge Services, 843.815.8494
Note:
Please identify Child & age of participant
Location:
Meet at the Learning Center Practice Tee
Price: Complimentary
Tuesday, July 3rd (continued) 6-8pm
Member Mingle & Summer Bonfire at the River Park *Royal Restrooms located at the River Park during July 4th Week
Brew Sampling & Wine Tasting ~ Glow Cups for All DJ & Karaoke from HH Entertainment Kidzplay ~ Sno Cones, Feather Extensions & Tattoos
We’ll mix and mingle at the River Park while sampling some of the Coolest Summer Brews and crisp White Wines. Try our collection of refreshing summer brews that are still packed with enough flavor to hold the attention of the most discerning of beer connoisseurs. We’ll have an assortment of tasty hors d’oeuvres and pub snacks to compliment our brews. Reservations: Concierge Services, 843.815.8494 Location:
Meet at the River Park, Patio
Price:
$15.00++ per person (adults & children)
Member Mingle & Summer Brew Tasting (8) Summer Favorite Brews in Glow Cups (6) Cool Summer Wines Non Alcoholic Beverages: Sodas, Lemonade, Blue Hawaiian & Water Lettuce Wraps of Tomato, Carrot, Cucumbers and Celery Carolina Cabbage Slaw, Jambalaya Pasta Salad and Cherry Tomato, Mozzarella & Pepperoncini Picks Pulled Smoked Turkey, Cranberry BBQ Sauce, Miniature Rolls Beer Battered Cod, Chicken Tenders, and Tater Tots Snow Cones, S’mores, Frosted Red, White & Blue Star Cookies Strawberry Dip & Summer Fruits
Wednesday, July 4th 7am
Liberty Bell 5K ~ Registration
8am
Liberty Bell Adults 5K Fun Run, Walk, or Bike
9am
Liberty Bell Children’s Fun Run, Walk
Following Awards Presentation & Continental at the Clubhouse Continental Menu ~ Double Blueberry Muffins, Sliced Banana Nut Bread Summer Fruits of Orange & Grapefruit Wedges, Granola & Kashi Bars Bottled Waters and Gatorades
Race Description The 5K fun race will begin at front of the clubhouse and throughout the property. The course race will differ from previous courses but finish up at the Grand Mall where friends and family can cheer loved ones on. We will have a mobile and stationary water station at the halfway point along the course route.
Registration Please submit the attached registration form by fax to 843.815.4630 or drop off at the Spa and Fitness Center. Registration will close at 12 pm on Monday, July 2nd….please do register in advance to ensure all participants receive a race t-shirt.
Adults & Children’s Awards Individual Awards will be presented to the top participant in each age division, as well as the overall winner both male and female. Top (3) places will be awarded for the children’s race. Reservations:
Spa & Fitness Center, 843.815.8985
Email:
bhcfitness@berkeleyhallclub.com
Location:
Meet at the Clubhouse, Front Entrance
Price:
$18.00 per adult, $12.00 per child
Wednesday, July 4th (continued) Cruise Times: 10am & 4pm Guided Pontoon Boat Cruises of the Scenic Okatie River Take a relaxing guided boat cruise up the Okatie River and enjoy the panoramic views of the marshes. From the cacophony of wildlife abounds from snapping shrimp to the flights of the marsh wren to the playful dolphins, all can be viewed during this cruise. Reservations: Concierge Services, 843.815.8494 Location:
Meet at the River Park, Dock
Price:
$25.00 per person, includes Cooler of Sodas and Waters $15.00 per person, children 12 and under
Wednesday, July 4th (continued) 11am-4pm Berkeley Hall Pool Party & Cookout *Pool Only Open for Guests of the Grand Pool Party due to Pool Occupancy Duo of Kizplay Slides ~ Pool Lawn, Patriotic Crafts
JLK Events ~Music, Trivia, Whacky Pool Games & Challenges Teens vs Adults ~ Volleyball Game ~ 2 pm
Let the games begin, join in the fun whether it’s testing your American Trivia knowledge, testing your skills at one of our poolside challenges, we’ll have a favor and prize for everyone! DJ, Jami Bodie will return to provide everyone’s favorite tunes! Don’t forget to take your buddy to the 27’ Roaring Rapids Slide and Pool alongside the Tropical Bounce Slide and Pool…something for everyone in the family. We’ll have a shaded slide viewing area for all to enjoy. Reservations: Concierge Services, 843.815.8494 Note:
Pool will be open only for Pool Party Participants (Age 4 & under Free)
Location:
Spa & Fitness Center, Outdoor Pool
Price:
$20.00++ Adults, $12.00++ Children includes Lunch, Favors, Slides & Prizes
(Pool Party) All American Lunch from 12-2 pm Cool Salad Display ~ Sweet Corn, Black Bean & Tomato with Chips, Fruit Cocktail, Green Salad, Firecracker Shrimp & Pasta, Albacore White Flake Tuna, Miniature Bakery Croissants Italian Hoagie ~ Pool Deck Beef Sliders or Kielbasa Sausage Chopped Onions, Pickles, Ketchup, Mustard, Soft Rolls, Condiments Buffalo or Ranch Chicken Wings ~ Blue Cheese or Ranch Dip Club Chips, Pretzels, Snack Bars Frozen Sweets ~ Frozen Pops, Watermelon Wedges, Ice Cream Bars, Sno Cones Iced Tea, Pink Lemonade, Iced Water (Member Charge Bar/Cocktails)
Wednesday, July 4th (continued) All Day
Flag Day Golf Tournament
You are cordially invited to participate in the Flag Day Golf Tournament. We hope that you will join us for a round of fellowship and spirited competition. No summer tournament would be complete without coolers of frozen towels as well as chilled watermelon wedges to beat the summer heat. Following play we will offer an optional American Lunch Cookout, not included in tournament fee. Players are encouraged to make their own tee times via ForeTees for this event; entry fee will be collected on the 1st tee prior to start for those who wish to participate. Location:
Check in to receive flag at the Practice Tee with a member of the
Professional Staff
Price:
Entry fee will be $10.00 per player and will go towards prizes.
All Day
Flag Day Golf Tournament
Format
Individual Stroke Play
Course:
North & South Golf Courses
Entries: Individual tee times may be made directly onto ForeTees on the Berkeley Hall website or you may call the golf shop directly at 843.815.8444.
Wednesday, July 4th (continued) 6:30-9:30pm 4th Annual Berkeley Hall Patriotic Celebration Low Country Cookout, Carnival & Fireworks Showcase Family Check In & Photo Booth Printable for each Family All Families will be asked to come through the front of the clubhouse to get their glow necklace & table assignments. JKL Events will be here to take printable family fun photos at the Grand Entrance. Full Service Bar Zones including Liquor, Beer, Wine & Sodas/Waters
Play Zone: Equalizer Bungee Competition, Basketball Sports Bounce House, Face Painting & Carnival Games All Fan Interactive Basketball Sports Bounce House in which you can bounce, climb AND then slide! Are you ready for this!!! Prepare yourself, you are about to have the time of your life! It is you versus your competitor, you both put on harness and are attached to a Bungee. Ready, Set, Go...the first to get four ball in the basket wins. Sounds easy...not so much! It is as much fun to watch as it is to play. Play Zone will include a visit from our most friendly clown & character guests. Be sure to test your skills at our Whacky Carnival Games.
Patriotic Evening Entertainment Let JLK Events Celebrate with Music throughout the Decades, Dancing, Show Tunes and Patriotic Songs
Wednesday, July 4th (continued) 4th Annual Berkeley Hall Patriotic Celebration Grand Buffet Refreshing Chilled Summer Salads Sweet & Sour Vegetable Salad Chilled Marinated White & Green Asparagus, Herb Vinaigrette Miniature Buffalo Mozzarella & Cherry Tomato Salad, Balsamic Reduction Potato Egg Salad, Sweet Tri-Colored Cabbage Slaw, Greek Feta Pasta Salad Mini Sweet Corn and Cheese Biscuits, Home-Style Rolls, Honey Butter
Southern Accompaniments Stewed Green Casserole, Macaroni & Cheese, Root Beer Baked Beans, Sweet Corn on Cob with Butter Chips Deep Fry Station Carolina Fried Chicken, Pickles, Corn Fritters and Cornmeal Fried Shrimp Kids Fried Chicken Tenders Spicy Remoulade, Creamy Tarter, Wild Honey Mustard Off the Grill ~ Beef & Vegetable Brochettes or Swordfish Steaks Peppered Beef Brochettes, Vegetable or Swordfish Steaks in Lemon Caper Butter In the Smoker Whole Smoked Hog and Butts, with Trio of BBQ Sauces Grand Finale Dessert Apple Cinnamon Cobblers, Banana’s in Brown Sugar, Hot Fudge, Ice Cream & Toppings Miniature Cookies, Fresh Berries, Shortcake Station, Sweet Watermelon and Berkeley Chocolates Reservations:
Concierge Services, 843.815.8494
Location:
Clubhouse, Grand Lawn
Table Assignments: Tables will be reserved by Family or Open Club Tables Price:
$58.00++ Adults, $35.00++ Children (Ages 4-11)
Thursday, July 5th 9am-11am Adult & Child (3-Hole) Golf Tournament at the Learning Center You are cordially invited to participate in the Adult & Child Golf Tournament at the Learning Center. We hope that you will join us for fun (3-Hole) Golf Tournament. Families are encouraged to contact the golf shop to register for this special event. Location:
Check in to receive tournament instructions at the Learning Center with a member of the Professional Staff
Format:
Par Three Challenge
Entries:
Families are encouraged to contact the golf shop to register for this special event.
Cruise Times: 10am, 4pm, & 6pm Guided Pontoon Boat Cruises of the Scenic Okatie River Take a relaxing guided boat cruise up the Okatie River and enjoy the panoramic views of the marshes. From the cacophony of wildlife abounds from snapping shrimp to the flights of the marsh wren to the playful dolphins, all can be viewed during this cruise. Reservations: Concierge Services, 843.815.8494 Location:
Meet at the River Park, Dock
Price:
$25.00 per person, includes Cooler of Sodas and Waters $15.00 per person, children 12 and under
4pm
Cold Blood Adventures Reptile Show
Very special show to see rare and rescued reptiles. Brian Nettles will share his current collection of rescued and very friendly reptiles while providing education about each one, their habitats, feeding, mating and day to day life. Come by and see the show. Limited to 25 children. Reservations: Concierge Services, 843.815.8494 Location:
Meet in the Berkeley Room
Price: Complimentary
Thursday, July 5th (continued) 11am-4pm Berkeley Hall Pool Party & Cookout *Pool Only Open for Guests of the Grand Pool Party due to Pool Occupancy Duo of Kizplay Slides ~ Pool Lawn, Patriotic Crafts
JLK Events ~Music, Trivia, Whacky Pool Games & Challenges Teens vs Adults ~ Volleyball Game ~ 2 pm
Let the games begin, join in the fun whether it’s testing your American Trivia knowledge, testing your skills at one of our poolside challenges, we’ll have a favor and prize for everyone! DJ, Jami Bodie will return to provide everyone’s favorite tunes! Don’t forget to take your buddy to the 27’ Roaring Rapids Slide and Pool alongside the Tropical Bounce Slide and Pool…something for everyone in the family. We’ll have a shaded slide viewing area for all to enjoy. Reservations: Concierge Services, 843.815.8494 Note:
Pool will be open only for Pool Party Participants (Age 4 & under Free)
Location:
Spa & Fitness Center, Outdoor Pool
Price:
$20.00++ Adults, $12.00++ Children includes Lunch, Favors, Slides & Prizes
(Pool Party) All American Lunch from 12-2 pm Cool Salad Display ~ Sweet Corn, Black Bean & Tomato with Chips, Fruit Cocktail, Chicken Salad, Green Salad with Assorted Dressings Deli Bar ~ Deli Meats, Sliced Breads & Rolls, Condiments Grilled Chicken & Pineapple Kabobs, Peanut Butter & Jelly Squares Club Chips, Pretzels, Snack Bars Frozen Sweets ~ Frozen Pops, Watermelon Wedges, Ice Cream Bars, Sno Cones Iced Tea, Pink Lemonade, Iced Water
Friday, July 6th Guided Pontoon Boat Cruises of the Scenic Okatie River Cruise Times: 10am, 4pm, & 6pm Take a relaxing guided boat cruise up the Okatie River and enjoy the panoramic views of the marshes. From the cacophony of wildlife abounds from snapping shrimp to the flights of the marsh wren to the playful dolphins, all can be viewed during this cruise. Reservations: Location: Price:
Concierge Services, 843.815.8494 Meet at the River Park, Dock $25.00 per person, includes Cooler of Sodas and Waters $15.00 per person, children 12 and under
10-11:30am Tennis Clinic & Round Robin ~ Adults & Children Come and enjoy an hour and half of tennis, beginning at 10:00 am. The clinic will include active drill situations based on the player’s levels in a fun environment. You will hit plenty of balls and enjoy time with fellow members and guests. There will be a round robin mini tournament based on skill. Come on out, we look forward to seeing you on the courts. Note: Children will receive Clinic Instruction for the duration. Reservations: Spa & Fitness Center, 843.815.8985 Email:
bhcfitness@berkeleyhallclub.com
Location:
Meet at the Spa & Fitness Center, Rear Verandah
Price:
$10.00 per participant
Note:
Please identify Child (Age) or Adult (Level)
10-11am
Complimentary Adult Golf Clinic, Learning Center
Complimentary Clinics for adults will include swing instruction, exciting prize challenges, and valuable information to better your game. Let our experienced golf professionals enhance your golfing experience with great instruction and drills to better your game this summer. Reservations: Concierge Services, 843.815.8494 Note: Please identify Adult participant Location: Meet at the Learning Center Practice Tee Price:
Complimentary
Friday, July 6th (continued) 3pm
Stars & Stripes 9-Hole Twilight Golf
Join us for a relaxed, fun afternoon of 9-holes of golf with your golf buddies and their guests. Entry fee will $5 per player and will go towards prizes. Normal guest fees apply. Please register via ForeTees or by calling the golf shop at (843) 815-8444. Reservations: Golf Shop, 843.815.8444 Location:
South Course
Price:
$5.00 per player
6-9pm
1st Friday Grill Nights & Lawn Games
Guitarist: David Bohn Our 1st Friday Grill Nights continue as a conclusion to the holiday week with Guitarist David Bohn. We’ll have a few lawn challenges for those looking to test their outdoor game skills. Reservations: Concierge Services, 843.815.8494 Location:
Clubhouse Verandah
Price:
$17.00++ per person, $10.00++ children
1st Friday Grill Nights Stars & Stripes Menu Crisp Greens, Cherry Tomatoes, Red Onions, Green Peppers, Cucumbers, Sweet Carrots, Croutons, Parmesan Reggiano Cheese, Italian Vinaigrette & Creamy Blue Cheese Sweet Grape & Fruit Salad Toss, Mediterranean Pesto Pasta Salad, Cilantro Cous Cous Sirloin Steak with appropriate trimmings, Fresh Catch of Day, Grilled Chicken Breast, Baked Potato Station Children’s Station: Spaghetti & Meatballs, Garlic Bread Georgia Peach Cobbler, Vanilla Ice Cream, Chocolate Brownies
LIBERTY BELL 5K FUN RUN, WALK OR BIKE REGISTRATION FORM* Name: Member Name or Parent’s Name (if under 18 yrs of age): Age: Gender: Adult Shirt Size: ___Medium ___Large ___XL ___XXL Child Shirt Size: ___Medium ___Large 5K Registration Fee:
_____$18.00 Adults
_____$12.00 Children
**All Charges will be placed onto Member account.**
ACKNOWLEDGEMENT, WAIVER & RELEASE FROM LIABILITY WAIVER: I know that running a road race is a potentially hazardous activity. I should not enter and participate unless I am medically able and properly trained. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I assume all risks associated with running in the Berkeley Hall Liberty Bell 5K Race on July 4th including, but not limited to falls, contacts with other participants, the effects of the weather, including high heat and humidity, traffic and condition of the road, all such risks being known and appreciated by me. Having read this release and knowing these facts and in consideration of your accepting my entry, I for myself and anyone entitle to my behalf, waive and release Berkeley Hall Club and any or all sponsors, contributors of the race, their agents, and any persons assisting with the race and their successors for all claims or liabilities of any kind arising out of participation in the race event though the liability may arise out of negligence or carelessness on the part of the person referred to in this waiver. I also grant permission for the use of any photographs, motion pictures, recordings or any other record of my participation in this event for any legitimate purpose. In the event that this race cannot be held on July 5th due to circumstances beyond the control of Berkeley Hall, e.g. unsafe weather conditions, the race will be canceled and will not be rescheduled for another date this year. Since the majority of the race – such as entry forms, awards, t-shirts, favors, occur prior to the race; entry fees may not be refunded.
( ) I hereby certify that I am (18) years of age or older, I have read this document; and I understand its contents. ( ) I am under the age of (18) years – my parent/grandparent/guardian has read and completed the waiver below. Printed Name: Signature: Date:
PARENT/GUARDIAN WAIVER FOR MINOR: If the application is under 18 years of age, the parents or guardians must execute in addition to the standard waiver above, the following waiver and consent. The undersigned
(parent/grandparent/guardian)
referred to as the parent and natural guardian or legal guardian of (minor’s name) does hereby represent that he/she is, in fact, acting in such capacity and agrees to save and hold harmless an indemnify each and all parties herein named on this form and releases from all liability, loss, cost, claim or damage whatsoever that may be imposed upon said releases because of any defect in or lack of such capacity to so act and release said releases on behalf of both of the undersigned. CONSENT TO MEDICAL TREATMENT OF MINOR: I hereby authorize any duly authorized doctor, emergency technician, hospital or other medical facility to treat said minor for the purpose of attempting to treat or relieve any injuries received by said minor while he/ she was a participant or observer in the event. I authorize any licensed physician to perform any procedure which he/she deems advisable in attempting to treat or relieve any injuries or any related unhealthy conditions of said minor that he/she may encounter during any necessary operation. I consent to the administration of anesthesia as deemed advisable by any licensed physician. I realize and appreciate that there is a possibility of complications and unforeseen consequences in any medical treatment, and I assume any such risk on the behalf of myself and said minor. I acknowledge that no warranty is being made as to the results or any treatments.
Parent/Grandparents/Guardian Signature: Date: