The Ohio State University Men’s Lacrosse Specialty Positions Mini-Camps
Thank you for selecting The Ohio State University Men’s Lacrosse – Specialty Positions Mini-Camps. We are confident that you will both enjoy and benefit from the instruction at these camps. Included in this packet is a Parent Consent, Waiver and Release Form. PLEASE COMPLETE THIS FORM AND BRING IT WITH YOU TO THE CAMP CHECK-IN. DO NOT MAIL THIS FORM TO US PRIOR TO THE CAMP. This form is required to participate in order to participate in the Mini-Camps. Players who do not bring the form to check-in will not be permitted to participate. Check-in time: Grades 3 -8: Check-in will take place from 7:00 AM - 7:45 AM on January 18 at the Woody Hayes Athletic Center, located at 535 Irving Schottenstein Drive, Columbus, OH 43210. Camp will begin promptly at 8:00 am and end at 11 am. Grades 9-12: Check-in will take place from 10:00 PM – 10:45 PM on January 18t at the Woody Hayes Athletic Center, located at 535 Irving Schottenstein Drive, Columbus, OH 43210. Camp will begin promptly at 11 am and end at 2 pm. Directions: Please note that Map Quest, Google and other internet-based mapping services may not recognize the address for the Woody Hayes Athletic Center (535 Irving Schottenstein Drive, Columbus, OH 43210). If you would like door-to-door driving directions to the Woody Hayes Athletic Center, please visit www.osu.edu/map. Parking: Campers and their parents should park in the lots adjacent to the Woody Hayes Athletic Center, Jesse Owens Memorial Stadium and Bill Davis Stadium. The use of University parking lots requires a permit. Hourly permits may be purchased using the selfservice Pay-n-Display machines located in these lots. For more details on the Pay-nDisplay machines, visit: http://tp.osu.edu/visitorsmain/parking/payndisplay.shtml
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What to bring: Players will need to provide all of their own lacrosse protective equipment. Helmet, stick, gloves, shoulder pads and mouthpiece will be required for every session. Goalies must bring their own equipment. No exceptions will be made. Our playing surface is Astroplay. Players may wear sneakers, turf shoes or cleats. Players without the necessary equipment will not be allowed to participate for safety reasons. Refunds: A full refund less a $20 administrative fee will be issued for any cancellation received at least 2 weeks prior to the start of the camp session. Any cancellations received less than 2 weeks prior to the start of the camp session will not be eligible for any refund. Cancellation notices and refund requests must be submitted on the Refund Request Form available at ohiostatebuckeyes.com/camps. The camp fee cannot be transferred to any other Ohio State sports camp or camper. Refunds will be processed after the camps have ended. Questions: If you have any questions, please contact Assistant Coach Bill Katsaros at: Office: Email: 614 688-4275 Katsaros.2@osu.edu
We look forward to seeing you in January.
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BRING THIS COMPLETED FORM TO CAMP CHECK-IN
CAMP ______________________________ DATES _____________________________
DO NOT MAIL PRIOR TO CAMP
CAMPER NAME______________________________
PARENT CONSENT, WAIVER AND RELEASE In consideration of the Ohio State University Buckeye Sports Camp acceptance of ___________________________ as a student in Sports camp for the period in the dates mentioned above, and in return for the opportunity to participate in this camp: It is agreed that all risks attendant to watching and/or participating in camp activities, including, but not limited to bodily injury, are assumed by the student and his parents and/or legal guardian and that this assumption is acknowledged, approved, and agreed to by said student and his parents and/or legal guardian as indicated by the signature hereto. Buckeye Sports Camps will be financially responsible for and has insurance that will cover most injuries/accidents occurring during camp, but only as secondary coverage after parent’s/guardian’s insurance has paid. I hereby certify that the above named camper is physically able to participate in The Ohio State University Buckeye Sports Camp and that I know of no physical impairments which would in any manner limit his/her participation in such a program. I hereby grant permission for physicians, dentists, other licensed health care providers and their designees employed by The Ohio State University to administer outpatient medical, surgical, or dental services as appropriate, or necessary antigens or other injections, to perform emergency procedures as necessary or to refer to duly licensed medical personnel when indicated. In consideration for honoring my child's request to participate in the above activity, I, for myself, my executors, administrators, and assigns, do hereby release and forever discharge The Ohio State University, and its Board of Trustees, its respective entities, administrators, faculty members, employees, agents, and students from any claims that I might have myself or could bring on my child's behalf with regard to damages, demands, or any actions whatsoever, including those based on negligence or failure to supervise, in any manner arising out of my child's participation in this activity. I also hereby agree to save, hold harmless, and indemnify The Ohio State University, its Board of Trustees, and/or its respective entities, administrators, faculty members, employees, agents, and students against any and all claims, including claims of negligence or failure to supervise, which my child might bring against them as a result of his or her participation in the above activity. I recognize that this Release means that I am giving up, among other things, rights to sue the University or its Board of Trustees, its respective entities, administrators, faculty members, employees, agents or students for injuries, damages or losses that my child may incur. ______________________________________________ _____________________________________ Parent or Legal Guardian Signature Date ____________________________________________________________________________________________________________ MEDICAL INFORMATION Medical InsuranceCompany_____________________________________________________________________________________ Address_______________________________________City___________________________State_________Zip________________ Phone ___________________________________ Group # _________________________ I.D.# _____________________________ Medical History (if pertinent): ____________________________________________________________________________________________________________ Allergies, present medications, special considerations: ____________________________________________________________________________________________________________ Parent/Guardian: _____________________________________________________________________________________________ Address: _______________________________________________ City: ________________________________________________ State: _________________________ Zip: __________________________ ____________________________________________________________________________________________________________ EMERGENCY MEDICAL INFORMATION _________________________________________________ ( ______ ) _________________________________________ (HOME) NAME AC PHONE _________________________________________________ ( ______ ) __________________________________________(WORK) NAME AC PHONE Page 3 of 3