Camp Registration

Essx Showcase

Date: August 09, 2026

Location: Landon Athletics

Schedule / Notes: TBD

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First Name

Last Name

Date of Birth

Street Address

City, State, Zip Code

Home Phone

Cell Phone

E-mail Address

School

Personal Best Height

Accomplishments (optional)

Emergency Contact

Emergency Contact Phone

Family Doctor

Family Doctor Phone

Insurance Company

Policy #

Any Medical Conditions

Camp Waiver and Release

Please open and review the Camp Waiver and Release before submitting.

I have read and agree to the Camp Waiver and Release.

Parent/Guardian Consent

Required if the camper will be under 18 on August 09, 2026.

A parent/guardian has read and agrees to the Camp Waiver and Release.

Parent/Guardian Name

Parent/Guardian Email

Send me updates about upcoming meets and camps.

Accepted payment methods are cash and check. Make checks payable to Landon Athletics.

Camp Waiver

Camp Waiver and Release

Camp Participation Waiver and Release

I understand that pole vault, track and field training, running, jumping, strength work, drills, use of poles, standards, boxes, landing mats, and related camp activities involve inherent and significant risks. These risks include, without limitation, falls, collision with equipment or other people, equipment failure, landing-area or runway hazards, weather conditions, overexertion, illness or communicable disease, serious bodily injury, permanent disability, paralysis, and death.

I represent that the participant is physically able to participate, is not impaired by alcohol, drugs, medication, illness, or other condition that would make participation unsafe, and will stop participating and notify staff if the participant feels unsafe, injured, ill, or unable to continue. The participant agrees to follow all coach and staff instructions, facility rules, and safety procedures.

Release, Assumption of Risk, and Indemnity

To the fullest extent permitted by applicable law, I voluntarily assume all risks arising from participation in camp activities and release, waive, and covenant not to sue Landon Athletics, the camp directors, coaches, staff, volunteers, organizers, sponsors, officials, host organizations, facility owners or operators, and each of their officers, employees, contractors, agents, representatives, successors, and assigns from any claim, demand, liability, loss, damage, cost, or expense arising out of or related to participation in the camp, except to the extent a claim cannot legally be released under applicable law.

I further agree, to the fullest extent permitted by applicable law, to indemnify, defend, and hold harmless the released parties from claims or expenses, including reasonable attorneys' fees, arising from the participant's conduct, failure to follow rules or instructions, use of unsafe or improperly rated equipment, or any claim brought by or on behalf of the participant that is not legally barred by this release.

Medical Authorization and Insurance

I authorize camp staff to obtain or provide first aid, emergency medical care, emergency transportation, and related treatment when staff believes it is necessary. I understand that I am responsible for medical, ambulance, hospital, and related costs and that the participant should maintain appropriate health insurance.

Rules and Procedures

Always follow the prescribed warm-up to reduce injury risk.
Always follow technique and safety instructions from coaches. Do not improvise.
If in doubt, stop and ask a coach before proceeding.
Never use a pole rated below the participant's body weight.
Never release handgrip from the pole until safely over the landing area.
Never allow handgrip to exceed the height advised by coaches.
Always check poles and equipment for defects before use.
Always follow manufacturer guidelines on pole usage.

Parent/Guardian Agreement

If the participant is under 18, the parent or legal guardian confirms that they have authority to accept this agreement for the minor participant, consents to the minor's participation, accepts the medical authorization above, and agrees to the release, assumption of risk, and indemnity terms to the fullest extent permitted by applicable law.

Media Permission and Severability

I grant Landon Athletics and the camp organizers permission to use the participant's name, image, likeness, voice, video, photographs, athletic performance, and biographical information for camp, event, and athletics promotion, without compensation, except that this permission does not authorize product or service endorsements without additional consent.

I have read this agreement carefully, understand that it affects substantial legal rights, and intend my electronic acceptance to be a binding signature. If any provision is held invalid or unenforceable, the remaining provisions will remain in effect.