Informed Consent and Release

Informed Consent and Release

This form must be completed and submitted with payment before you will be allowed to participate.

 

I hereby grant permission for myself/child to attend the WVA Pole Vault Camp.  I verify that I/my child has had a physical exam in the past year and is capable to participate in activities related to pole vaulting. I agree to indemnify, hold harmless, and defend Tyler Knight, WVA, their agents, employees and sponsors from any and all liability for the injury to myself/my child. I understand that track and field, and in particular pole vaulting and many related activities are potentially dangerous and could pose rick of injury.  Should medical attention be necessary, I hereby authorize any physician or trainer selected by the camp personnel to conduct medical or surgical procedure.  In addition, I hereby grant permission for WVA Vault Camp to use any photographs or videotapes of camp related activities for the purpose of advertising or educational material development.

I HAVE READ AND UNDERSTOOD, AND I AGREE WITH THE INFORMED CONSENT AND RELEASE OUTLINED AS IT RELATES TO MYSELF/CHILD.