Youth Football Camp — The Wallace Foundation

The Wallace Foundation 3rd Annual Youth Football Camp Registration Form
Name*

First NameLast Name
Parent's Name*

First NameLast Name
Parent's E-mail*
example@example.com
Parent's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Age*
Shirt Size*
Dietary Needs + Allergy Restrictions
Dietary & Allergy restrictions must be indicated here to receive a personalized meal ticket for lunch. To ensure safety, special requests will not be provided at meal functions without a meal ticket.

General Release & Waiver

Please sign and complete.
For good and valuable consideration, the sufficiency of which I, THE ABOVE NAMED PARENT or LEGAL GUARDIAN, hereby acknowledge, I, personally and on behalf of and as the parent and/or legal guardian of THE ABOVE NAMED PARTICIPATING CAMPER, and anyone acting on my behalf, including but not limited to attorneys, representatives, agents, heirs, executors, administrators, assigns, insurers, predecessors, successors or any other person or entity asserting claims through me, agree to release, indemnify, defend and hold harmless: The Wallace Foundation, East Baton Rouge Parish School System, Glen Oaks High School and all of their respective directors, officers, shareholders, subsidiaries, partners, agents, sponsors, employees, successors, parents, beneficiaries, heirs, executors, administrators, assigns and affiliates thereof (collectively, "Releasees"), from and against any and all claims, suits, losses, damages, expenses, costs, and liabilities (including reasonable attorneys' and consultants' fees and expenses) which hereinafter may accrue or arise against the Releasees and which in any way arise out of or are in anyway related to (a) my child's participation in the Wallace Foundation Youth Football Camps and/or (b) the use of my child's name, photograph, quotation, and likeness in any advertising or promotions which relate to the Camps*

I agree
I, PERSONALLY AND ON BEHALF OF MY CHILD, UNDERSTAND THE DANGER OF PERSONAL INJURY OR DEATH THAT MAY RESULT FROM PLAYING FOOTBALL AND PARTICIPATING IN THE CAMPS INCLUDING BUT NOT LIMITED TO FALLING, BEING STRUCK BY THE FOOTBALL OR ANOTHER INDIVIDUAL.*

I agree
I, PERSONALLY AND ON BEHALF OF MY CHILD, ASSUME ANY AND ALL RISK THAT IS IN ANY WAY ASSOCIATED WITH, RELATED TO OR OCCURS AS A RESULT OF MY CHILD'S PARTICIPATION IN THE CAMPS. I, PERSONALLY AND ON BEHALF OF MY CHILD, ASSUME ANY AND ALL RISK RESULTING FROM CONTRACTING COVID-19 AS A RESULT OF MY CHILD'S PARTICIPATION IN THE CAMPS, AND UNDERSTAND THAT THE SPREAD OF A COMMUNICABLE DISEASE, SUCH AS COVID-19, IS AN INHERENT RISK OF PARTICIPATION IN THE CAMPS, NOTWITHSTANDING ANY SAFETY PRECAUTIONS THAT THE CAMPS MAY TAKE, WHICH MAKES IT IMPOSSIBLE TO ENSURE THE COMPLETE SAFETY OF THE PARTICIPANT. NEITHER PARENTS NOR THE PARTICIPANT SHALL HOLD THE RELEASEES LIABLE IN THE EVENT THAT THE PARTICIPANT SUFFERS ANY ILLNESS OR INJURY AS A RESULT OF BEING EXPOSED TO, OR CONTRACTS COVID-19 AT THE CAMPS. PARENTS AND THE PARTICIPANT HEREBY ASSERT THAT THE CHILD’S PARTICIPATION IN THE CAMPS IS COMPLETELY VOLUNTARY. PARENTS AND THE PARTICIPANT KNOWINGLY ASSUME THE RISK OF CONTRACTING COVID-19 AT THE CAMPS. THE PARTICIPANT AGREES TO ABIDE BY ALL CAMP RULES TO MINIMIZE THE RISK OF INJURY TO THE PARTICIPANT AND OTHERS.*

I agree
I, HEREBY CERTIFY THAT I AM 18 YEARS OF AGE OR OLDER AND REPRESENT THAT EITHER I AM THE PARENT OR LEGAL GUARDIAN OF THE PARTICIPANT NAMED ABOVE.*

I agree
I, HAVE READ AND AGREE TO THE "PROGRAM POLICIES" AND "WEBSITE PRIVACY POLICY" SET FORTH ON THE WWW.WALLACEFOUNDATIONBR.ORG WEBSITE HEADER AND ALSO FOUND ON THE TOP OF THIS PAGE.*

I agree
Parent or Legal Guardian Signature*
Date Signed*

MonthDayYear
Date
By entering name and date above and clicking SUBMIT button below I certify that I have 1) read the "Waiver--Release and Hold Harmless Agreement, The Wallace Foundation Youth Football Camps”, 2) that I am the custodial parent(s) and/or legal guardian(s) of the person designated as Participant above, and 3) that I am over the age of eighteen (18) years of age. This action will constitute an electronic signature in lieu of an actual signature and evidences the parties’ mutual intent to enter into a valid and binding contract that will satisfy all applicable legal requirements. This Agreement shall constitute an “original” when printed from electronic files or records established and maintained in the normal course of business.*

I agree
Should be Empty:

Get ready for an electrifying experience at our upcoming youth football camp on Saturday, June 6th at Glen Oaks High School.

From 9 am to 12 pm, join us for a day filled with surprises, skill-building drills, and inspiring moments. Our youth football camp is a non-tackle, fundamentals-only program, focused on teaching essential skills and fostering a love for the game in a safe and supportive environment.

Registration begins at 8 am. it is FREE for elementary and middle school children ages 6-12.

Lunch will be provided to campers, free of charge.

But here's the kicker – we have an incredible guest speaker lined up to share their wisdom and passion for the game, promising an unforgettable addition to our lineup. With limited space available, be sure to secure your spot now before registration closes on may 23rd!

Don't miss out on this opportunity to learn, grow, and make memories that last a lifetime.

The Wallace Foundation 3rd Annual Youth Football Camp Registration Form

General Release & Waiver

T H E W A L L A C E F O U N D A T I O N