FINANCIAL

INFORMATION
PROMISSORY
NOTE

&
WAIVERS
 Financial Agreement and Contract

This financial agreement is made between:

_________________________________ (Orangeburg Calhoun Prep Academy) and

_________________________________ (Athlete/Parent or Guardian)

For the athletic fees ($3000) at Orangeburg Calhoun Prep Academy:

____________________________________(Address)

_____________________________________(City, State and zip code)

The contract is for one year starting on June 1, 2011 and is for the amount of $3000.00 a year.
The athletic fee will be covered through financial aid and students loans if the following steps
are completed by the athlete and/or parent. A $500 deposit is required by June 1, 2011.

 Athlete/Parent or Guardian is responsible for completing 2010-2011 and 2011-2012 free

application for FAFSA.
 Athlete/Parent or Guardian is responsible for applying for student loan through
Orangeburg-Calhoun Technical College.
 Athlete/Parent or Guardian is responsible for completing an Application for admission
to OCTech and OCPA.

If the proper steps and procedures are not followed by the athlete or parent then they are
responsible for the athletic fee for the athlete to participate. If the deposit and fee is not paid
then the athlete will not be able to participate or enroll in OCPA.

*NO REFUND ONCE SEASON STARTS

__________________________________________ ______________________________

(Athlete) (Date) (Phone)

__________________________________________ ______________________________

(Parent/Guardian) (Date) (Phone)

__________________________________________ ______________________________

(Athletic Director) (Date) (Phone)

 Orangeburg Calhoun Prep Academy
Equipment Fees Include-$500 Program Cost Include-$2,500
Uniforms, Equipment & Apparel Players Marketing & Promotions
Helmet Highlight Videos
Girdle Players Profile
Shoulder Pads Digital Video Distribution
Thigh Pads
Knee Pads Travel Game Day Expenses
Mouthpiece * Transportation Cost
Pre-Game Meal
Practice Gear Post-Game Meal
Practice Jersey Hotel Cost
Practice Pants
Academic Development
Player Pack ACT/SAT Prep
T-Shirt/Shorts * ACT/SAT Test
Sweat Suit * (Football) GED Preparation Classes
Polo * Individual and Group Tutorial
Cleats * (Football)
Sneakers (Basketball)* Athletic Development
Socks * Athletic Trainer

Uniforms Strength and Conditioning Training

Jersey- Black & White Speed/Agility Training
Game Pants- Black
Personal Development
Specialty Equipment Financial Management Courses
Ankle, Knee and Shoulder Brace Camera/Media Coaching
Travel Bag Academic Advisement

*Becomes personal items, all other items will be returned at the end of the season
 OCPA PROMISSORY NOTE
Principal amount: $ 3000.00 DATE, _____/_____/_____

I, ___________________________________ (Borrower) promise to pay

Orangeburg Calhoun Prep Academy the sum Three Thousand Dollars
($3000.00) for athletic fees.

Payment shall be made in __________ installments, consisting of $ 500

deposit on or before the 1st day of June and continue through October 1st,
or until the principal is paid in full.

OR, Borrower will pay one lump payment on or before: 9/1/2011.

If the Borrower fails to make an installment payment when due or fails to

comply with any other term of this promissory note, the loan will be
considered in default. A late penalty charge of $250 will be assessed until
the account is brought current inclusive of the late charges, interest and
applicable fees.

Payments will be applied first to interest and then to principal.

This note may be prepaid by the Borrower at any time in whole or in part
without premium or penalty.

In the event of the Borrower's death, the unpaid indebtedness remaining

on the note shall be canceled.

The Borrower must promptly inform the Lender of any change in name or
address.

If the Lender prevails in a lawsuit to collect on this note, Borrower will pay
Lender's court costs, collection agency costs, and attorney's fees in an
amount the court finds to be reasonable.

IN WITNESS WHEREOF, I set my hand under seal this ____th day of

_______________, 20___ and I acknowledge receipt of a completed copy
of this instrument.

_________________________________
Borrower’s Signature
Permanent Address:
_____________________________________________________
Social Security Number: ______________________________
Driver's Licence Number: ______________________________
 Orangeburg Calhoun Prep Academy

ATHLETIC WAIVER & FIELD RELEASE

Participant’s Name: ____________________________ Parent/Guardian: __________________________

Address: _________________________ City: ______________________ State: ______ Zip: _______

Cell Phone: _________________________ Home Phone: _______________________

Year Graduated: _______ School: ____________________________ City/State: __________________

Last Physical: ___________ Age: ________ Date of Birth: ______ Height: ______ Weight: _______

Emergency Contact Name: _________________________ Emergency Contact Phone #: _____________

Does the athlete have any physical conditions or allergies? If yes, please note: _______________________

WAIVER: I understand that in taking part of these try-outs and/or athletic activities, there is a risk of
injury that I am assuming. The risk of such injury will NOT be covered by the program, its insurance or
the facility in which this event is taking place. I agree to hold harmless the team, program, coaches or my
teammates for any injuries received while participating in any Orangeburg Calhoun Prep Academy
sponsored or associated events.

I hereby certify that I am in normal health, have had a physical within the past year and am capable of
participating in any and all Orangeburg Calhoun Prep Academy (OCPA) sponsored and associated events.

I give consent for authorized OCPA representatives to take me for medical care in an emergency situation.
I understand that all efforts will be made to notify the emergency contact listed above prior to such action
and the expenses, if any, will be settled by me.

I acknowledge and agree that my participation in the Orangeburg Calhoun Prep Academy to be held at any
athletic facility (Stadium Football Field) or gym secured by the Orangeburg Calhoun Prep Academy, LLC
during the 2011-2012 season is completely voluntary. I also agree that the Orangeburg Calhoun Prep
Academy, LLC nor any athletic facility (Stadium Football Field) or gym in which athletic games/events
held will NOT be held liable for any injuries incurred on the respective properties.

___________________________________________________________________
Signature of Applicant (Parent printed name & signature if applicant if under 18yrs)

Date____________

Orangeburg Calhoun Prep Academy

 RELEASE OF INFORMATION

I, ________________________________________________, the undersigned, hereby

authorize the following individual, agency, institution or organization, Orangeburg

Calhoun Prep Academy, LLC, to release and provide information to any entity regarding

my academic/athletic affairs. I also, hereby authorize any college/university, sports program

or athletic coach/program to release all requested information on me to Orangeburg

Calhoun Prep Academy, LLC. I understand that this release is valid for a period of two

years from the signed date below.

_____________________________ ___________________

Signature Date