WAIVER OF LIABILITY

Camper Waiver and Release of Liability 

In consideration of being allowed to participate in the 6x6 Goalie Academy Summer Camp (The “Camp”) sponsored by 6x6 Goalie Academy, LLC. (“Company’) and related events and activities, the undersigned acknowledges, understand, and agrees that:

1. I hereby agree to behave in a responsible manner during the camp week. I understand that anyone who does not follow the rules of the camp will be sent home.

2. I hereby agree to have my child transported to medical care and treated if necessary.

3. The risk of injury from the activities involved in the program of the camp is significant, including potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist; and

4. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the company, its officers, shareholders, directors, officials, agents, coaches and or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the camp (the “releases”_ and I assume full responsibility for my participation; and

5. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such attention of the nearest staff/official immediately; and

6. I, for myself and on behalf of my hears, assigns, personal representatives and next of kin, hereby release and hold harmless the releases with respect to any and all injury, disability, death, or loss, or damage to person or property, whether arising from the negligence of the releases or otherwise unless caused by the willful, wanton and intentional conduct of the releases.

7. I authorize the camp to treat and/or transport my child to the Hospital for any medical treatment.

This is to certify that I, as parent/guardian with legal responsibility for this camper, do consent and agree to his foregoing waiver and release of all the releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the releases from any and all liabilities incident to the camper’s involvement or participation in the camp as provided above. 

MEDICAL

I hereby give my permission, consent and authorization for any medical treatment deemed necessary by a hospital or physician. I appoint the event coordinator and/or director my lawful agent with power to authorize and consent to the administration of medical treatment during the event. In case of such accident or illness, I give permission for medical treatment to be given to me as deemed appropriate. I will assume responsibility for any medical treatment as deemed appropriate. I will assume responsibility for any medical bills incurred on my behalf.

MEDICAL WAIVER - Typing your name below serves as your signature. A Parent/Legal Guardian must electronically sign if Participant is under 18 years of age or a dependent on parent’s insurance.

PHYSICAL CONDITIONS

Please list any physical conditions that we should be aware of (allergies, special needs, dietary restrictions, etc.). If no conditions exist, please type none.

HEALTH INSURANCE INFORMATION

EMERGENCY CONTACT INFORMATION

MEDIA RELEASE

Cancellation Policy:

• If 6x6 chooses to cancel this years camp for reasons unforeseen, everyone will receive a FULL refund.
• HOWEVER, if you choose to cancel for any reason there will be a $50 non-refundable fee charged to cover administrative fees.  

• The 6x6 Goalie Academy could revert back to a COMMUTER ONLY camp. That would be determined by Hope College based on the current COVID guidelines leading up to the first day of camp.