STEVE SPURRIER FOOTBALL CAMP, LLC CAMP WAIVER AND RELEASE by olliegoblue33

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									             STEVE SPURRIER FOOTBALL CAMP, LLC
       CAMP WAIVER AND RELEASE OF LIABILITY AGREEMENT

In consideration for my child being permitted to participate in the USC Football Camp (a
privately owned and operated camp by Steve Spurrier Football Camp, LLC), related events and
activities, the undersigned acknowledge and agrees that: as the natural parent and/or as the
legally authorized guardian, do hereby for myself, my spouse, my child, and on behalf of my/our
heirs, personal representatives, and assigns, agree not to sue and hereby release, waive,
discharge, hold harmless and indemnify and forever defend Steve Spurrier Football Camp, LLC,
the University of South Carolina, its members of the Board of Trustees, individually and
collectively, their officers, employees, servants, agents, and directors, from any and all liability,
losses, claims, actions, suits, procedures, demands, rights, and causes of action of whatever
nature, in law and equity, for any and all known or unknown, foreseen or unforeseen, bodily or
personal injuries, death and permanent injury, illnesses, damage to property, or other losses, and
any consequences thereof, including expenses, costs, and attorney’s fees, as may be sustained by
my child or me arising out of or in any way associated with my child’s participation in the Steve
Spurrier Football Camp, LLC, or travel incident thereto, whether by negligence or not to the
fullest extent permitted by law.

The risk of serious injury to my child from these camp activities does exist including the
potential for permanent disability and death. I understand and fully acknowledge that my child’s
participation in these activities is solely at our own risk and I assume full responsibility. I hereby
further declare that my child has had a physical examination within the past one (1) year and is
physically able to participate in all camp activities. Moreover, I hereby understand and affirm
that the camp only provides for excess medical insurance and any charges including deductibles
related to the medical care provided to my child will be the responsibility of my primary
insurance carrier or me.


I HAVE CAREFULLY REVIEWED AND VOLUNTARILY AGREE TO
THE TERMS OF THIS CAMP WAIVER AND RELEASE OF LIABILITY
AGREEMENT.

_______________________________                       ________________________________
Parent/Guardian Signature (Required)                   Camper’s First/Last Name (Please Print)


_______________________________                       __________________________________
Parent/Guardian (Please Print Full Name)                      Date
                        Medical Consent and Treatment/Release
                       (to be completed and signed by parent/guardian)
The law requires that parental permission be obtained for operative procedures on minors. The
following consent form should be signed by the parents so that such procedures may promptly
occur. However, no operation will be performed, except in emergency situations, without
parents being contacted and fully informed. I give permission for such diagnostic, therapeutic
and operative procedures as may be deemed necessary for my son.
I authorize release of any medical information to process insurance claims and request payment
of benefits to the physicians or supplier for services described. I understand that should the
insurance not cover this illness/injury, I will be responsible for payment in full of any charges
incurred.

                                      MEDICAL HISTORY

Is there a known history of:                                Circle One
A. Birth Deformities (one eye, kidney, etc.)               Yes    NO
B. Medical conditions currently under treatment            Yes    NO
C. Preexisting injury currently under treatment            Yes    NO
D. Fractures of other disability type injuries             Yes    NO
E. Allergy (drugs, food, asthma, etc.)                     Yes    NO
F. Mental disorder or convulsions                          Yes    NO
G. Known past illness of more than one week                Yes    NO
H. Contact lens or glasses                                 Yes    NO
Explain above questions answered “yes”
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________

I hereby state that the Steve Spurrier Mini-Camp is not responsible for any preexisting injury or
illness of the above camper prior to the first day the camper registers, and the Steve Spurrier
Football Mini Camp will assume responsibility only for injuries incurred while the above camper
is participating in camp activities under supervision during enrolled camping period.

__________________________________                         ______________________________
   Signature (Parent/Guardian)                                 Camper’s First/Last Name


__________________________________                         ______________________________
Please Print Full Name of Parent/Guardian                            Date

								
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