TASBA SUMMER CAMP 2015
(Please complete and return)
Athlete: _________________________ D.O.B. _________ Today’s Date: _________________
Address: ___________________________________________________T-shirt Size: _________
City: _______________________ State: __________________ Zip: ____________________
Day Phone: ________________ Evening Phone: _____________________________________
Fax: _________________ E-mail: ________________________________________________
Please check the 2 - Month Athletic Development Session(s) you will be attending
___ Session I – June 1 - July 30, 2015 ( Monday - Thursday) 6:00 pm – 8:00 pm
AGES 12 & ABOVE
___ Session I – June 1 - July 30, 2015 ( Monday - Thursday) 7:00 pm – 9:00 pm
Please check the appropriate payment
______ $150 per MONTH for 1 day per week Training Session per week
______ $250 Per MONTH for 2 or more Weekly Training Sessions per week
THERE ARE NO REFUNDS for workouts not used
Method of Payment
I am enclosing a check in the amount of $ _______ made payable to:
TASBA 7632 Why 71 West Austin, Texas 78735
There are no make-ups or refunds for sessions missed! I.e.…you sign up for 2 days per week but 2 weeks you only made it to class once a week. We will NOT prorate this. ONE exception, if you get injured playing in your games in the first week of any session, we will refund 50% of your fee.
Coach Reid doesn’t only train players, but develops them into young adults and gives them the mental fortitude needed to play baseball beyond high school. Baseball is a grind and I learned that at a young age, but the work Pat does at TASBA gets you ready for that grind and gives you a head start against the other players in the country. If your player wants to do it big in the game of baseball, there’s no better place to start the journey than here at TASBA. As Pat always closes, “Greatness is not by Accident.”
Grant Schneider, Arizona State University Class of 2018
TASBA TRAINING ACADEMY
Waiver and Release of Liability AND Insurance Waiver
In consideration of being allowed to participate in any way in the TASBA SPORTS TRAINING or National Elite Gymnastics (NEG) related events, and activities, undersigned acknowledges, appreciates, and agrees that:
The risk of injury from the activities in this program is significant, including the 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, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, or others, and assume full responsibility for my participation, and, I willingly agree to comply with 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 to the attention of the nearest official immediately, and, I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS TASBA, National Elite Gymnastics, their officers, official agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the event (“Release”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss of or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.
By my signature, I am informing Coach Patrick Reid and his staff that they are in no way liable for any injuries, medical expenses, or damages. WE HAVE MADE THE CHOICE TO USE OUR OWN INSURANCE PROGRAM. We acknowledge that we have named the choice on behalf of our child without any interference from anyone serving or employed by TASBA in any capacity.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
X___________________________________ Date Signed:_________________
FOR PARTICIPANT OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
THIS IS TO CERTIFY THAT I, PARENT/GUARDIAN WITH LEGAL RESPONSIBILITY FOR THIS PARTICIPANT, DO CONSENT AND AGREE TO HIS/HER RELEASE AS PROVIDED ABOVE OF ALL THE RELEASES, AND FOR MYSELF, MY HEIRS, ASSIGNS, AND NEXT OF KIN, I RELEASE AND AGREE TO INDEMNIFY THE RELEASEES FROM ANY AND ALL LIABILITIES INCIDENT TO MY MINOR CHILD’S INVOLVEMENT OF PARTICIPATION IN THESE PROGRAMS AS PROVIDED ABOVE, EVEN IF ARISING FROM THEIR NEGLIGENCE.
X_____________________________________ Date Signed:____________
LEGAL GUARDIAN SIGNATURE
EMERGENCY PHONE NUMBER: ________________________________________