ELEVATE 35 BREAKOUT CAMP

* First Name:

* Last Name:

Instagram:

Twitter:

* City:

* State:

* Phone:

* Email:

Birthdate:

* High School Grad Class (Based on 2018/2019 School Year):

* Jersey Top (Size) Men's Cut::

* Position:

* Height:

* PARENT/GUARDIAN #1:

* Cell Phone:

PARENT/GUARDIAN #2:

Cell Phone:

* AAU Club Information:

Coach Name:

* Coach Number:

* WAIVER INFORMATION PARTICIPATION AUTHORIZATION AND RELEASE:

In exchange for permission to participate in the ELEVATE 35 BREAKOUT CAMP (hereafter known as a ELEVATE 35 ) Event, I hereby enter into the following release and waiver of liability, assumption of risk and indemnity agreement. I, for myself, my heirs, spouse, executors, administrators, personal representatives and assignees, waive, release, discharge, indemnify, hold harmless and agree not to sue ELEVATE 35, its officers, directors, shareholders, employees, agents, landlords, lessees, sponsors, representatives, volunteers, affiliates and franchisees (hereafter the "Released Parties") from, any and all liability, responsibility, damages, losses, claims, demands, actions, suits, judgments, costs and expenses (including attorneys fees) resulting from personal injury, accidents, illnesses, death and/or property loss caused in any manner, including the simple, active or passive negligence of the Released Parties, by my participation in this ELEVATE 35 Event. I acknowledge that this ELEVATE 35 Event is designed to stress my body physically in an attempt to show prospective college coaches and/or ELEVATE 35 that my level of fitness and skills warrant their consideration of further evaluation. I knowingly assume all risks relating to my participation in this ELEVATE 35 Event. I knowingly execute this agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. I have read this agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. This agreement is intended to be as broad and inclusive as permitted by law. If any portion of this agreement is held invalid, the remaining portions will continue in full force and effect.**I also acknowledge that any cancellation is non-refundable and will be used as credit towards any ELEVATE 35 event held within the year from date of registration**

I/we agree with the above *

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ELEVATE 35 BREAKOUT CAMP (Durham, NC) 10/21/2018