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CTK is hosting a football camp for rising 5th—8th graders July 15th - 17th from 9:00 a.m. to 12 noon. (Monday through Wednesday) at the CTK Athletic fields. The cost is $150 per attendee. Please complete a separate form for each attendee. 
Player Namerequired
First Name
Last Name
Rising Grade

Minor Participant Waiver and Release of Claim

Roman Catholic Diocese of Charlotte - Christ the King Catholic High School
 
Dear Parent or Legal Guardian:
 
Your son/daughter/ward has elected to participate in the Diocesan-sponsored activity that is described above. Participation in the activity may require personal transportation to locations away from your home site. This activity will take place under the guidance and supervision of adult chaperones, coaches, diocesan employees, and/or other volunteers. 
If you would like the child (player) named above to participate in this event, please check the box below indicating your consent, indemnification, and release of liability. 
Parent/Guardian Namerequired
First Name
Last Name
Emergency Contactrequired
First Name
Last Name
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The undersigned, on behalf of themselves, their heirs, successors, and assigns, and on behalf of the above named child, their heirs, successors, and assigns, hereby affirmatively states and agrees as follows:
 
I hereby waive, release, and agree to indemnify, hold harmless and defend the Roman Catholic Diocese of Charlotte, included but not limited to any and all associated institutions and/or entities, its/their officers, directors, employees, volunteers, coaches, representatives, participating individuals and agents (collectively referred to as the "Diocese") from any and all claims arising from or in any way connected with the activity referred to herein, or in connection with any illness or injury (including death) and/or the cost of medical treatment in connection therewith, without limitation. The above shall include reasonable attorney's fees and expenses incurred by the Diocese in any action brought against them as a result of such claim(s), without limitation. I consent to the method of transportation and the conditions and supervision of said event and/or activity. As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above-named minor child. 
 
In case of an emergency, I give my permission for the above named child to be taken to a physician and/or hospital, by either the supervisor in charge, or by an adult authorized by the supervisor in charge, and to be administered any and all medication reasonably necessary for treatment. I understand that every reasonable effort will be made to contact me. If I cannot be reached, however, I hereby give permission to hospitalize and secure proper treatment (including surgery and medication) for the above named child. The cost of any medical care or treatment obtained for the benefit of the above named child shall be at my expense and not paid by the Diocese.
 
I, on behalf of my family, heirs, and assigns, hereby grant to the Parish/School/Agency and/or The Roman Catholic Diocese of Charlotte herein referred to collectively as the "Diocese," permission to record on photography film and/or video, whether digital or otherwise, pictures, images, and/or reproductions of my child(ren)'s participation and/or my family's participation in this activity. I agree that any or all of the material photographed may be used, in any form, as part of any future publications, brochure, social media, internet or other printed materials that the Diocese deems to be an appropriate use, and further that such use shall be without payment of fees, royalties, special credit or other compensation. I agree to indemnify and hold harmless the Diocese, its agents, representatives, and assigns from any and all claims regarding the use of said material. Furthermore, I hereby waive any and all claims that I may have, or hereafter acquire, regarding the use of said material by the Diocese, its agents, representatives and assigns. 
Waiver and Release of Claim
Does your child have any restrictions, limitations, special needs, and/or medical needs?
Acknowledgement of Responsibility
$150.00
Click the credit card box below to pay online or mail a check to CTKCHS, 2011 Crusader Way, Huntersville, NC 28078 attn: Brian Decker.

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<p>Drop a check to the front desk of mail to:</p> <p>Christ the King Catholic High School</p> <p>2011 Crusader Way</p> <p>Huntersville, NC 28078</p>