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SHS Speech and Debate Camp Liability waiver form

Student Name: Address:


Parent Names: Parent Cell Phone:
Grade: DOB:
School: Home Telephone:
Emergency Contact & Telephone No.:
Alternative​ Contact & Telephone No.:
Doctor Contact & Telephone No.:

IN CONSIDERATION of being permitted to send my (or our) child or children to the camp offered by Saratoga
High Speech and Debate Club and complete understanding that ​our club is a 501(c)(3) tax exempt
organization (EIN 77-0108042).

1. Acknowledges, agrees, and represents that the undersigned enters this agreement freely and voluntarily
with all information fully disclosed by Saratoga High Speech and Debate Booster Club.

2. Fully understands, as parent(s) or legal guardian of the aforementioned student, who will attend the speech
and debate camp, that my child’s participation in CAMP involves risk of accidents or personal injuries.
Therefore, on behalf of my child, my spouse/partner and myself, the undersigned has hereby agreed to
release, waive, discharge and covenant NOT to sue and to hold harmless CLUB, its board members, teachers,
contractors, volunteers, administrative officers, employees and any other associated personnel including
owners or landlords of the premises utilized by the CLUB, of and from any and all claims, actions and damages
for accidents, personal injuries, emotional distress, disabilities or death that my child or any of my family
members have or may have sustained as a result of participation in this CAMP.

3. Has further agreed to take full responsibility for my/our child(ren) to observe, follow and obey any and all
CLUB and CAMP rules.

4. Authorizes, if necessary, the CLUB to seek emergency medical treatment for my/our child(ren) at an
available medical facility at my/our own expenses. In the event that the undersigned should observe or
discover any unsafe personal conduct or unsafe physical condition on the premises used by the CLUB, the
undersigned has agreed to report the unsafe conduct or condition to Saratoga Speech and Debate Club
representative as soon as possible.

5. Further, the undersigned has agreed to take full financial responsibility for any damage to CAMP facilities
and equipment, or facilities or equipment used by the CLUB, caused by my child or family members or myself.

This acknowledgment of risk and waiver of liability, having been read thoroughly and understood completely, is
signed voluntarily as to its content and intent.

_______________________________________________________________________________________
(Parent or Legal Guardian Signature) (Date)