2014 NCS Clinic Only Registration

NCS 90 Minute Clinic Only Registration
Full Name*

First NameLast Name
E-mail*
To NCS Camp participants, the 90 minute clinic is FREE.

If you'd like to attend the Clinic Only for instructional training, you can register below.

The clinic will start shortly after NCS Evaluations comence.

If you plan to attend the Clinic ONLY, please arrive 30-45 minutes before posted scheduled start time of Clinic. *There is a chance the NCS Evaluations will finish ahead of schedule
Position*
School Name*
Graduation Year*
T-Shirt Size*
Phone Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
NCS Clinic Only
prevnext( X )
Oct 12- NCS Clinic Only (Lakeville South)$60.00

1 on 1 Private Lesson Discount$60.00

Quantity

June 1- NCS Clinic Only (Stillwater)$60.00

Total $0.00
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I Agree to the Clinic Terms and Conditions (Injury and Media Release Waiver) Read Below*

Yes

Special Teams Football Academy Consent, Waiver and Hold Harmless Agreement I understand and agree to the procedures and conditions requested by Special Teams Football Academy for registrations, deposits and refunds as specified by each Special Teams Football Academy Program. I understand the Special Teams Football Academy Programs are for instructional and training purposes, and I understand they stress repetitious training in specific sports skills. I acknowledge Special Teams Football Academy Programs involve, among other things, physical contact of the body with other persons or objects, including the ground, and at Special Teams Football Academy Programs I/my son/ward may incur a risk of injury. I attest and verify that I/my son/ward to be physically fit and have sufficiently trained to participate in this instruction. All Special Teams Football Academy participants are required (unless waived by Special Teams Football Academy) to be covered by personal medical insurance which must, be provided to Special Teams Football Academy prior to participating. Providing insurance information is for the protection of all participants, parents/guardians and Special Teams Football Academy in the event of any type of emergency. If you, or your son or ward will be under the age of 18 years while attending a Special Teams Football Academy Program, it is our policy to secure your consent for medical treatment. In case of illness or injury, permission is granted to have the participant treated at an appropriate medical facility. By submitting this on line registration, you are giving consent in advance for medical treatment. As a participant in the Special Teams Football Academy Program, I hereby state that I am aware of and accept the risk inherent in the program activities. I understand that Special Teams Football Academy may take photographs/videos of Special Teams Football Academy Program participants and related activities. I agree Special Teams Football Academy shall be the owner of these photographs/videos and may use said photographs/videos in the promotion of all Special Teams Football Academy related projects. (Participants accept responsibility to check with their athletic director or coach for questions regarding eligibility.) Participant may also ask to have copies of the photographs if interested. The undersigned does hereby agree to hold harmless and indemnify Special Teams Football Academy, Counselors, Coaches, Assistants, Employees or Owners, from any and all liability of injury, loss, damages, costs or expenses which are sustained, incurred or required arising out of the action of dependent/participant in the course of traveling to and from or participating in Special Teams Football Academy Programs. I acknowledge that I have read and fully understand this Special Teams Football Academy Consent, Waiver and Hold Harmless Agreement. ** Special Teams Football Academy policies are subject to change without notice **Special Teams Football Academy DBA Red River Entertainment & Event Promotions LLC Signature: _____________________________ Printed Signature: ___________________ Date: _______ (Revised 06/02/12)
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NCS 90 Minute Clinic Only Registration