Sport Camps
Sports Sampler Basketball Soccer
FaithKids Sports Academy at Faith Lutheran Church, 37635 Dequindre, Troy MI 48083.
This form is for children (Ages 3—Grade 8) who will attend
For Kids Age 3—Grade 8
Waiver of Liability, Disclaimer and Permission for FaithKids Sports Academy
Summer 2018
37655 Dequindre Troy, MI 48083
www.faithtroy.org/connect/sports-academy 03/27/18
www.faithtroy.org 248.689.4664
Signature of Parent or Guardian:_______________________________________________________Date:_____________________
I give my permission for free use of my child’s name and picture in any participation of FaithKids Sports Academy in future publicity for FaithKids Sports Academy.
provider at the direction of the event officials, sponsors, representatives and/or volunteers.
events would be injurious to my child’s health, or should my child become ill or injured, I consent to his or her removal and treatment by any physician or medical care
However, should employees, representatives or volunteers determine in their sole discretion that completion or participation in any FaithKids Sports Academy program
performing his/her duties during any FaithKids Sports Academy activity. I attest that my child is physically capable to participate in the FaithKids Sports Academy events.
sponsored event, including any physical injury by the negligence of Faith Lutheran Church, its employees, volunteers and other representatives or affiliates while
claims arising out of or relating to illness, physical injury, death, or other damages that may result to said individual while participating in a FaithKids Sports Academy
heirs and assigns) hereby release, discharge, and hold harmless Faith Lutheran Church, its employees, volunteers and other representatives or affiliates from and against any
accepting the registration of the named individual and permitting the voluntary participation of said individual in its programs. I (for myself as well as for my child, his/her
acknowledge that the programs of Faith Lutheran Church’s FaithKids Sports Academy are primarily administered by adults who are trained in first aid. In consideration for
I, the parent or guardian of the above named individual, acknowledge that participation in athletic events necessarily involves the risk of physical injury. I further
First and Last Name of Child___________________________________________________________________________________
by start date of class (your child will not be able to attend Sports Academy Class until we receive this form).
ONE FORM PER CHILD — Must be filled out by parent/guardian ONLY and received by Faith Lutheran Church
Sport Camps
Time
Course
$45
10am-11am Gym
1
Age 6-8
$45
11:30am-12:30pm Gym/Sports Fields
2
Sports Sampler (4 Days)
Age 3-6
$45
10am-11am Gym
3
6/26-28
Basketball Camp (4 Days)
GRADE 3-5
$70
11:30am-1:00pm Gym
4
7/16-19
Basketball Camp (4 Days)
GRADE 5-8
$70
10 am-11:30 am Gym
5
Soccer Camp GRADE (4 Days) 3-6
$70
10am-11:30am Sports Fields
6
Date
Class Name
6/18-21
Sports Sampler (4 Days)
Age 3-6
6/18-21
Little Kickers Soccer Camp (4 Days)
6/25-28
8/6-8/9
Age / Cost Grade
#
FaithKids Sports Academy at Faith Lutheran Church, 37635 Dequindre, Troy MI 48083.
This form is for children (Ages 3—Grade 8) who will attend
For Kids Age 3—Grade 8
Waiver of Liability, Disclaimer and Permission for FaithKids Sports Academy
Summer 2018
37655 Dequindre Troy, MI 48083
www.faithtroy.org/connect/sports-academy 03/27/18
www.faithtroy.org 248.689.4664
Signature of Parent or Guardian:_______________________________________________________Date:_____________________
I give my permission for free use of my child’s name and picture in any participation of FaithKids Sports Academy in future publicity for FaithKids Sports Academy.
provider at the direction of the event officials, sponsors, representatives and/or volunteers.
events would be injurious to my child’s health, or should my child become ill or injured, I consent to his or her removal and treatment by any physician or medical care
However, should employees, representatives or volunteers determine in their sole discretion that completion or participation in any FaithKids Sports Academy program
performing his/her duties during any FaithKids Sports Academy activity. I attest that my child is physically capable to participate in the FaithKids Sports Academy events.
sponsored event, including any physical injury by the negligence of Faith Lutheran Church, its employees, volunteers and other representatives or affiliates while
claims arising out of or relating to illness, physical injury, death, or other damages that may result to said individual while participating in a FaithKids Sports Academy
heirs and assigns) hereby release, discharge, and hold harmless Faith Lutheran Church, its employees, volunteers and other representatives or affiliates from and against any
accepting the registration of the named individual and permitting the voluntary participation of said individual in its programs. I (for myself as well as for my child, his/her
acknowledge that the programs of Faith Lutheran Church’s FaithKids Sports Academy are primarily administered by adults who are trained in first aid. In consideration for
I, the parent or guardian of the above named individual, acknowledge that participation in athletic events necessarily involves the risk of physical injury. I further
First and Last Name of Child___________________________________________________________________________________
by start date of class (your child will not be able to attend Sports Academy Class until we receive this form).
ONE FORM PER CHILD — Must be filled out by parent/guardian ONLY and received by Faith Lutheran Church
Sport Camps
Time
Course
$45
10am-11am Gym
1
Age 6-8
$45
11:30am-12:30pm Gym/Sports Fields
2
Sports Sampler (4 Days)
Age 3-6
$45
10am-11am Gym
3
6/26-28
Basketball Camp (4 Days)
GRADE 3-5
$70
11:30am-1:00pm Gym
4
7/16-19
Basketball Camp (4 Days)
GRADE 5-8
$70
10 am-11:30 am Gym
5
Soccer Camp GRADE (4 Days) 3-6
$70
10am-11:30am Sports Fields
6
Date
Class Name
6/18-21
Sports Sampler (4 Days)
Age 3-6
6/18-21
Little Kickers Soccer Camp (4 Days)
6/25-28
8/6-8/9
Age / Cost Grade
#
