CAMP SIGN UP FORM

Xcel Fitness & Sport Performance
ATHLETE RELEASE AND WAIVER
Please Read Carefully, Sign, and Mail In with Payment
Before engaging in any physical fitness program, you should consult with your personal physician and advise them of the nature of the program. Athlete/visitor/guest agrees that all exercises and/or courses are undertaken at his/her own risk.
The athlete/visitor/guest understands the procedures and exercises involved in instruction and participation as explained to him/her by a representative of Xcel.
The athlete/visitor/guest understands that there is a risk of personal injury involved in the course of instruction and with his/her knowledge agrees to indemnify and hold harmless Xcel, its instructors, employees and representatives from all losses caused by accident or injury to the athlete/visitor/guest, or to a third person, who may be a athlete/visitor/guest of the program, in the event that either the athlete/visitor/guest or said third person is injured in any way during the performance and execution of exercises, I agree and understand that Xcel, its instructors, employees or agents shall not be held liable or responsible for personal injuries or damaged or stolen articles inside or outside of the program.
I, THE UNDERSIGNED THOROUGHLY agree to and UNDERSTAND THE INFORMATION STATED ABOVE;

Agreed and ACCEPTED BY IF UNDER 18 PARENT/ Guardian
(Print Name)


(Sign Name)

________________________________
Date
_________________________________________________________________ATHLETE INFORMATION:
Name:___________________________________Age:____________Year:_______
Address:__________________________________Phone:____________________
Email_________________________________ Team:________________________
Phone(h)______________________________(c)___________________________
Cancelation Policy: You have up until 48 hours before camp starts to cancel, minus a $25 processing fee. You must call to cancel. After the camp starts, there are no fee refunds.

Complete this form and mail in with your check payable to: Nicole Tegeler
6207 Perrin Dr, Crestwood, KY 40014