ATHLETE'S NAME:______________________ AGE:________
ADDRESS:_______________________________________
______________________________________________________________________________PERSONAL RECORD (PR): ___________________
PHONE NUMBER: ____________________
EMAIL ADDRESS: _______________________________
RELEASE OF CLAIMS
It is my understanding that there are certain risks involved with participating in the pole vault.
In recognition of the possible dangers connected with pole vaulting and any physical activity, I hereby knowingly and voluntarily waive any right of cause of action of any kind whatsoever arising as the result of such activity, from which any liability may or could accrue to Morry Sanders, Steve Irwin, Arkansas Vault Club and it's officers, agents, employees, or instructors.
I understand by participating in this camp, I am, in no way, being recruited by the coaches or school associated with the production of this camp and I have permission from my school to participate.
If under eighteen (18) years of age, parent or legal guardian must sign.
______________________________________
Signature Date
______________________________________
Parent/Guardian Date
______________________________________
Coach Date
Make Check or Money Order payable to:
Arkansas Vault Club
149 River Road
Norman, AR 71960
