tree house productions presents
TREE HOUSE PRODUCTIONS PRESENTS:
Date: April 9th-12th Time: 4:15 PM–5:45 PM (5th-6th Gr. Boys/ Girls) (1st Session 5th & 6th Graders) 6:00 PM-7:30 PM (7th-8th Gr. Boys/Girls) (2nd Session 7th & 8th Graders) Location: Lewis & Clark Junior High School Cost: $60 w/ Camp Shirt Contact Information: For more information contact Coach Roundtree (618) 789-2451 or email [email protected] or Contact Coach Herndon at Lewis and Clark Junior High School.
2018 Tree-House Prod Basketball Camp Consent and Assumption of Risk Waiver
Please mail in Form March 20, 2018 for Camp Shirt size and order The undersigned hereby agrees to Indemnify and hold harmless TREE-H0USE PRODUCTIONS, Shawn Roundtree Sr. (Tree-House Prod.), Wood River - Hartford School District #15 (Jr. High and Elementary Schools), from any liability forany loss, damage, or injuries incurred by the undersigned or by the minor child of the undersigned of any facilities, programs, or activities owned, maintained or supervised by agents or employees of TREE-HOUSE PRODUCTIONS (Shawn Roundtree), Wood River – Hartford School District # 15, of the city of Wood River, Illinois. EACH CAMPER AND PARENT MUST COMPLETE HIS OR HER PORTION OF THE OFFICIAL CAMP FORM. Please PRINT complete information in the spaces below and have each player print his or her name with parent’s signature. In signing below, I VERIFY TO PLAY ON THE MENTIONED TEAM THAT IN CONSIDERATION OF YOUR ACCEPTING THIS ENTRY, I INTEND TO BE LEGALLY BOUND HEREBY TO MYSELF, MY HEIRS, EXECUTORS, AND ADMINISTRATORS, WAIVE AND RELEASE ANY AND ALL RIGHTS I MAY HAVE AGAINST TREE-HOUSE PRODUCTIONS, SHAWN ROUNDTREE, WOOD RIVER – HARTFORD SCHOOL DISTRICT # 15 (Jr. High and Elementary Schools), and their representatives for ANY and ALL INJURIES suffered to me or by me at the games, included, but not limited to negligence of WOOD RIVER - HARTFORD School District # 15, Tree-House Prod., Shawn Roundtree, and by SIGNING THIS I AM SAYING, “I understand and have read the facts regarding the tournament and hereby agree to abide by them and allow my son or daughter to play at his or her own risk.”
CAMPER: __________________________
_________________________ ______ SIGNATURE
AGE: ___ PARENT:
GRADE: ___
GENDER: ___
_____________________________ PRINT
ADDRESS:
SCHOOL: _______________ _____________________________ SIGNATURE
__________________________
Phone: ______________________
__________________________ Level: Never played ___
Shirt size
Novice___
Average____ Experience _______
Date: April 9th-12th Time: 4:15 PM–5:45 PM (5th-6th Gr. Boys/ Girls) (1st Session 5th & 6th Graders) 6:00 PM-7:30 PM (7th-8th Gr. Boys/Girls) (2nd Session 7th & 8th Graders) Location: Lewis & Clark Junior High School Cost: $60 w/ Camp Shirt Contact Information: For more information contact Coach Roundtree (618) 789-2451 or email [email protected] or Contact Coach Herndon at Lewis and Clark Junior High School.
2018 Tree-House Prod Basketball Camp Consent and Assumption of Risk Waiver
Please mail in Form March 20, 2018 for Camp Shirt size and order The undersigned hereby agrees to Indemnify and hold harmless TREE-H0USE PRODUCTIONS, Shawn Roundtree Sr. (Tree-House Prod.), Wood River - Hartford School District #15 (Jr. High and Elementary Schools), from any liability forany loss, damage, or injuries incurred by the undersigned or by the minor child of the undersigned of any facilities, programs, or activities owned, maintained or supervised by agents or employees of TREE-HOUSE PRODUCTIONS (Shawn Roundtree), Wood River – Hartford School District # 15, of the city of Wood River, Illinois. EACH CAMPER AND PARENT MUST COMPLETE HIS OR HER PORTION OF THE OFFICIAL CAMP FORM. Please PRINT complete information in the spaces below and have each player print his or her name with parent’s signature. In signing below, I VERIFY TO PLAY ON THE MENTIONED TEAM THAT IN CONSIDERATION OF YOUR ACCEPTING THIS ENTRY, I INTEND TO BE LEGALLY BOUND HEREBY TO MYSELF, MY HEIRS, EXECUTORS, AND ADMINISTRATORS, WAIVE AND RELEASE ANY AND ALL RIGHTS I MAY HAVE AGAINST TREE-HOUSE PRODUCTIONS, SHAWN ROUNDTREE, WOOD RIVER – HARTFORD SCHOOL DISTRICT # 15 (Jr. High and Elementary Schools), and their representatives for ANY and ALL INJURIES suffered to me or by me at the games, included, but not limited to negligence of WOOD RIVER - HARTFORD School District # 15, Tree-House Prod., Shawn Roundtree, and by SIGNING THIS I AM SAYING, “I understand and have read the facts regarding the tournament and hereby agree to abide by them and allow my son or daughter to play at his or her own risk.”
CAMPER: __________________________
_________________________ ______ SIGNATURE
AGE: ___ PARENT:
GRADE: ___
GENDER: ___
_____________________________ PRINT
ADDRESS:
SCHOOL: _______________ _____________________________ SIGNATURE
__________________________
Phone: ______________________
__________________________ Level: Never played ___
Shirt size
Novice___
Average____ Experience _______
