Athletic Training Student Aide Seminar
A t hl et ic Tr ai ning S t ude nt A i de Se mi na r
The Athletic Training Student Aide Seminar is designed to introduce students to the field of Athletic Training, while exposing them to other components under the sports medicine umbrella.
FREE
This is a half day Seminar that will include lectures as well as hands on practical sessions taught by staff members from Kettering Sports Medicine. Speakers include athletic trainers, physical therapists, physicians and other local Sports Medicine professionals.
Athletic Training Student Aide Seminar
Topics Will Include:
High Speed Treadmill Common Joint injuries Reformer and Stretching techniques Student Athletic Training Aide Etiquette and Expectations Athletic Taping Techniques
When: March 14, 2015 8:00am –12:00pm Where: Kettering Sports Medicine 4403 Far Hills Avenue, Kettering 45429 Cost: FREE
4403 FAR HILLS AVENUE KETTERING, OH 45429 KETTERINGSPORTSMEDICINE.ORG
Picture & Info Release Form I _____________________________, give my consent to the Kettering Health Network (KHN), its agents, officers, and employees for the taping, photographing, filming, or printing of my story, actions, or conduct. I acknowledge that KHN may wish to use the tapes, photographs, or films for educational, professional, medical, scientific, or promotional purposes. My likeness may also be used in KHN brochures, publications, booklets; or for use by the commercial news media, including, but not limited to newspapers, magazines, radio, television, films, or the internet. I DO NOT REQUIRE THAT MY NAME/IDENTITY BE KEPT CONFIDENTIAL. I authorize and grant permission to the Kettering Health Network, its officers, agents, and employees to produce and distribute its tapes, publications, photographs, and films without my further permission or without compensation to me. I recognize and understand that all photographs, films, and tapes (whether they are originals, copies, negatives, or proofs) shall become the property of KHN. Those items may be used, produced, reproduced, or distributed without obtaining my prior approval.
Required Waiver and Release for Participation In consideration of being allowed to participate in the 2015 Kettering Sports Medicine Center Athletic Training Student Aide Seminar, I/We release and agree to hold Kettering Sports Medicine Center, Kettering Medical Center, its agents, and employees from any and all claims which I may now or which may hereafter arise in connection with my participation in the Athletic Training Student Aide Seminar. I have been advised that the Athletic Training Student Aide Seminar will involve my participation in some moderate exercise. I acknowledge that I am aware of the risks of injury involved from such exercises and I represent that I am aware of nothing in my physical condition which would or should prohibit me from engaging in such exercises.
Signature of Participant Signature of Parent or Guardian Date
Emergency Contact Information
Date: March 14, 2015
Relationship Home Phone #
Address______________________Zip________
Witness_________________________________
Home Address City, State, Zip Area Code and Phone Number School and Graduation Year Previous Experience as a Student Aide? Y/N
Number of Years_____
Date of Birth
Name (please print)
Phone__________________________________
Last Name, First Name
Participants Name (please print)
Event Name: Athletic Training Student Aide Seminar
Signature________________________________
Registration
Cell Phone # Work Phone #
Email Address Special needs/requests Return Registration Form to: Kettering Sports Medicine Attn: Student Aide Seminar 4403 Far Hills Avenue Kettering, OH 45429 Questions? Please Contact: Laura Stafford at [email protected] or 937-395-3928 Registration is required by Monday, March 2, 2015
The Athletic Training Student Aide Seminar is designed to introduce students to the field of Athletic Training, while exposing them to other components under the sports medicine umbrella.
FREE
This is a half day Seminar that will include lectures as well as hands on practical sessions taught by staff members from Kettering Sports Medicine. Speakers include athletic trainers, physical therapists, physicians and other local Sports Medicine professionals.
Athletic Training Student Aide Seminar
Topics Will Include:
High Speed Treadmill Common Joint injuries Reformer and Stretching techniques Student Athletic Training Aide Etiquette and Expectations Athletic Taping Techniques
When: March 14, 2015 8:00am –12:00pm Where: Kettering Sports Medicine 4403 Far Hills Avenue, Kettering 45429 Cost: FREE
4403 FAR HILLS AVENUE KETTERING, OH 45429 KETTERINGSPORTSMEDICINE.ORG
Picture & Info Release Form I _____________________________, give my consent to the Kettering Health Network (KHN), its agents, officers, and employees for the taping, photographing, filming, or printing of my story, actions, or conduct. I acknowledge that KHN may wish to use the tapes, photographs, or films for educational, professional, medical, scientific, or promotional purposes. My likeness may also be used in KHN brochures, publications, booklets; or for use by the commercial news media, including, but not limited to newspapers, magazines, radio, television, films, or the internet. I DO NOT REQUIRE THAT MY NAME/IDENTITY BE KEPT CONFIDENTIAL. I authorize and grant permission to the Kettering Health Network, its officers, agents, and employees to produce and distribute its tapes, publications, photographs, and films without my further permission or without compensation to me. I recognize and understand that all photographs, films, and tapes (whether they are originals, copies, negatives, or proofs) shall become the property of KHN. Those items may be used, produced, reproduced, or distributed without obtaining my prior approval.
Required Waiver and Release for Participation In consideration of being allowed to participate in the 2015 Kettering Sports Medicine Center Athletic Training Student Aide Seminar, I/We release and agree to hold Kettering Sports Medicine Center, Kettering Medical Center, its agents, and employees from any and all claims which I may now or which may hereafter arise in connection with my participation in the Athletic Training Student Aide Seminar. I have been advised that the Athletic Training Student Aide Seminar will involve my participation in some moderate exercise. I acknowledge that I am aware of the risks of injury involved from such exercises and I represent that I am aware of nothing in my physical condition which would or should prohibit me from engaging in such exercises.
Signature of Participant Signature of Parent or Guardian Date
Emergency Contact Information
Date: March 14, 2015
Relationship Home Phone #
Address______________________Zip________
Witness_________________________________
Home Address City, State, Zip Area Code and Phone Number School and Graduation Year Previous Experience as a Student Aide? Y/N
Number of Years_____
Date of Birth
Name (please print)
Phone__________________________________
Last Name, First Name
Participants Name (please print)
Event Name: Athletic Training Student Aide Seminar
Signature________________________________
Registration
Cell Phone # Work Phone #
Email Address Special needs/requests Return Registration Form to: Kettering Sports Medicine Attn: Student Aide Seminar 4403 Far Hills Avenue Kettering, OH 45429 Questions? Please Contact: Laura Stafford at [email protected] or 937-395-3928 Registration is required by Monday, March 2, 2015
