METHODIST UNIVERSITY WAIVER OF LIABILITY

I hereby waive and absolve the Methodist University Summer Camps and Methodist University of any and all liability and responsibility for injuries, sickness, accidents, and/or acts of God incurred during participation in and/or travel to and from the Methodist University PTM Tennis Camp for ________________________________ (name of child). In consideration of my application being accepted, I, intending to be legally bound, do hereby, my heirs, executor, and administration, waive, release, and forever discharge any and all rights and claims for damage which I may have or which may hereafter accrue to me against Methodist University Summer Camps, the Camp Director, or their respective employees, office, agents, representative, successors, and/or assignee, for any and all damages which may be sustained or suffered by me in connection with my association with or participation in, or rising out of my traveling to and returning from said school to be participated in on the campus of Methodist University. In the event of injury/accident/sickness, camp officials are to contact the designated adult below.

_______________________________	___________________________

Signature of Child	Signature of Parent/Guardian

IN CASE OF EMERGENCY, CALL:

Name:_________________________________RELATIONSHIP:_____________________

Address: _________________________________________________________________

_________________________________________________________________________

HOME PHONE: (____)_________________BUSINESS PHONE: (____)_______________

DOCTOR’S NAME: (____)_______________DOCTOR’S PHONE: (____)______________

INSURANCE COMPANY: _________________POLICY NUMBER: ___________________

*In event of injury/accident/sickness requiring immediate treatment, I request that very effort be made to contact me. If I cannot be reached, I authorize Methodist University summer camp officials to authorize appropriate treatment.

SIGNATURE OF PARENT/GUARDIAN: _____________________________