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Registration and Waiver Form for Participation in Royals Baseball/Tucson CHAMPS Academy
! Arizona’s International Baseball Consortium, LLC
I understand that participation in baseball related activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I have carefully considered the risk involved and have given consent for my child to participate in this activity. I also understand that participation in this activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release Arizona ’s International Baseball Consortium LLC / Tucson CHAMPS Academy,the activity coordinators, and all employees, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.
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In case of emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the medical provider selected by the adult leader in charge to secure proper treatment. Tucson CHAMPS Medical providers are authorized to disclose to the adult in charge examination findings, Academy, Inc. test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant's parents or guardian, ADDRESS and/or determination of the participant's ability to continue in the program activities. 33 West Congress Street, Suite 215 Tucson, Arizona 85701
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I hereby authorize any images or video footage taken of my youth (under 18 years of PHONE age), in whole or in part, individually or in conjunction with other images and video 520. 230.1020 Ext 700 footage, taken during this event, and to be used for media purposes including promotional presentations and marketing campaigns. FAX 520. 230.1020
I waive rights to privacy and compensation, which I may have in connection with such use of my youth’s name and likeness, including rights to be written copy that may be WEB www.azinterntionalbaseball.com created in connection with video production, editing and promotion therewith. I am over 19 years-of-age and the parent or legal guardian of the youth, and I have read this waiver and am familiar with its content.
! Name of Participant:________________________________________DOB____________ ! Parent / Guardian Name (Please Print):_________________________________________ ! Home Address:_____________________________________________________________ !
Email:___________________________________Phone Number:_____________________ List any Medical Allergies or Conditions. -
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Signature:_________________________________________Date:____________________