MasterCoaches Players Camp

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone *

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Cell Phone *

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Emergency #1 Contact Person *

First Name

Last Name

Emergency #1 Primary Phone *

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Emergency #1 Secondary Phone

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Emergency #2 Contact Person *

First Name

Last Name

Emergency #2 Primary Phone *

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Emergency #2 Secondary Phone

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H.S. Coach

First Name

Last Name

MEDIA WAIVER *

BY SIGNING THIS FORM, I hereby agree to be filmed, videotaped, and photographed, and to have my name, image, picture, likeness, voice, and biographical information otherwise recorded, in any media, during any event covered by MasterCoaches LLC liability insurance (the “footage”). I hereby grant MasterCoaches LLC, with no financial or other compensation due to me, full right and license to use and to authorize third parties to use, in all media, the footage for (1) news and information purposes, (2) promotion of the specific competition(s) in which I participate, (3) promotion of the sport, and (4) promotion of MasterCoaches LLC, provided that, in no event may MasterCoaches LLC use or authorize the commercial use of the footage in any manner that would imply my endorsement of any other company, product, or MasterCoaches LLC service, without my written permission. MasterCoaches LLC – MEDIA WAIVER

I have read and agree to the Media Release

Please READ the following LIABILITY and ASSUMPTION of RISK AGREEMENT CAREFULLY. *

They include release of liability and waiver of legal rights, and deprive you of the ability to sue certain parties. By agreeing electronically, you acknowledge that you have both read and understood all text presented to you as part of the registration process. I hereby authorize the staff of Volleyball MasterCoaches, hereinafter referred to as VMC, to act for me according to their best judgment in any emergency requiring medical attention. I, the registrant, willingly agree to comply with and abide by the rules of VMC, and its affiliated organizations and sponsors including customary terms and conditions as regards protection against infectious diseases. If, however, I observe any unusual or significant hazards during my presence or participation, I will remove myself from participation and bring such attention to the nearest staff member immediately. Recognizing the possibility of physical injury associated with volleyball and/or transportation to and from the same, which transportation I hereby authorize, and in consideration for VMC accepting the registrant for its volleyball programs and activities, I knowingly and freely assume such risks, both known and unknown, even in the event of unintended/possible negligence by VMC or others and assume full responsibility for my participation. Participation includes possible exposure to an illness from infectious diseases, including but not limited to MRSA, influenza, and Covid 19. While rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, hereby release and hold harmless VMC, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessors of premises used to conduct event against any claims by or on behalf of the registrant as a result of the registrant’s participation in the program/event with respect to any and all illness, disability, death, or loss or damage to person or property. I have read this release of liability and assumption of risk agreement, fully understand its terms, and understand I have given up substantial rights by signing it and signing it freely and voluntarily.

By writing my Full Name and my Cell Number freely and voluntarily, I acknowledge that I have read this release of LIABILITY and ASSUMPTION of RISK AGREEMENT, fully understand its terms, and understand I have given up substantial rights.

Signature - Cell Number- Liability & Assumption Risk Agreement *

REQUIRED - Camper (if over 18 years old) or Parent (if camper under 18 years old)

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