Registration Form - River Rouge School District

4th – 8th Grade
River Rouge School District
Position-Based
Youth Football Camp
River Rouge High School 1460 W Coolidge Hwy • River Rouge, MI 48218
June 26-27
CAMP TIMES: 8:00am – 3:00pm
CAMP FEE:
FREE – lunch will also be provided
REGISTRATION DEADLINE: June 12, 2015
Registration form available online: www.detroitrefinery.com
This camp will take registration forms on a first come first serve basis.
Limited Spots Available – All registration forms must be returned to:
River Rouge High School
1460 W Coolidge Hwy.
River Rouge, MI 48218
Questions – call (313) 297-4787
Sponsored by:
®
Fueling the American Spirit.
4th-8th Grade
River Rouge School District
Youth Football Camp
June 26-27
at River Rouge High School
1460 W Coolidge Hwy • River Rouge, MI
4th-8th Grade, Position-based
River Rouge School District Youth Football Camp
Player Registration Form
Player Name:
Address:
Apartment #:
City:
State:
Zip:
Phone:
Email:
Height:
Weight:
Age (As of 6/26/15)
Grade next fall:
School Name:
Position:
Quarterback
Years played:
Wide Receiver
Tight End/Running Back
Offensive/Defensive Linebacker
Shirt Size:
CAMP TIMES: 8:00am – 3:00pm
CAMP FEE:
FREE – lunch will also be provided
REGISTRATION DEADLINE:June 12, 2015
Registration form available online: This camp will take registration forms on a first come first serve basis.
Limited Spots Available – All registration forms must be returned to:
River Rouge High School
Sponsored by:
1460 W Coolidge Hwy.
River Rouge, MI 48218
Questions – call (313) 297-4787
www.detroitrefinery.com
®
Fueling the American Spirit.
PARENTAL PERMISSION WAIVER:
I hereby authorize the directors and staff of The River Rouge School District Youth Football Camp (“Camp”) to
act in my behalf using their best judgment in any emergency, including medical emergency, and to render preventative, first-aid, and/or emergency treatment that they deem necessary to my child’s health and well-being. On
behalf of myself and my child, I hereby waive against and release the Camp, its employees, directors, sponsors
(including Marathon Petroleum Corporation, and its affiliates, directors, officers, shareholders, employees, and
agents), suppliers and facilities from any and all liability for illness or injury incurred while my child is attending
Camp. I know of no mental or physical problems that might adversely affect my child’s ability to participate in
this Camp. I hereby grant the Camp permission to use any photographs or video of my child for promotional purposes. I have read the Youth Football Camp registration form and information and agree to its terms and
conditions.
On behalf of myself and my child, I hereby agree to release and forever discharge the City of River Rouge, a
municipal corporation, and its officers, agents, departments, elected and appointed officials, River Rouge School
District, volunteers, employees, sponsors (including Marathon Petroleum Corporation, and its affiliates, directors,
officers, shareholders, employees, and agents), suppliers, and facilities from any and all claims, liabilities, or law-
suits, including legal costs and attorney fees that may result from my child’s participation in this Camp, and agree
not to sue any of the foregoing related to my child’s participation in this Camp.
On behalf of myself and my child, I agree to defend, indemnify and hold harmless the City of River Rouge, its
officers, agents, departments, elected and appointed officials, River Rouge School District, volunteers, employees,
sponsors (including Marathon Petroleum Corporation, and its affiliates, directors, officers, shareholders, employees, and agents), suppliers, and facilities from and against any and all claims and causes of action of any kind
arising out of my child’s participation in this Camp.
Knowing, understanding, and fully appreciating all possible risk, on behalf of myself and my child, I do hereby
expressly, voluntarily, and willingly assume all risks and dangers associated with my child’s participation in this
Camp. These risks could result in damage to property, personal and/or bodily injury or death.
I CONSENT TO MY MINOR CHILD’S PARTICIPATION IN THIS CAMP. I HAVE CAREFULLY READ
THIS AGREEMENT, FULLY UNDERSTAND ITS CONTENTS, AND HAVE SIGNED IT OF MY OWN
FREE WILL.
Student Name:
Parent/Guardian’s Signature:
Date:
Return completed forms to: River Rouge High School, 1460 W Coolidge Hwy., River Rouge, MI 48218
NOTE: Parental Permission Waiver Form must be signed, dated, and received by our office prior
to your child participating.
Players will not be able to participate without a completed signed & dated form!