OUA Soccer Final Four Youth Camp

Email address *

PLAYER INFORMATION

Which camp would you like to register for? *

Saturday, November 1st Sunday, November 2nd

Name: *

DOB (MM/DD/YYYY): *

Address: *

City: *

Phone: *

ADDITIONAL PARTICIPANT INFORMATION

Important Medical Conditions of Participatnts

Participant's Approx. Height & Weight

Participated in Organized Socce Before?

How Did You Hear About OUA Soccer Final Four Youth Camp?

EMERGENCY CONTACT INFORMATION

Name: *

Phone Number: *

WAIVER

I , as the parent/guardian of _____________________________(name of participant) on behalf of myself, members of my family, my heirs, executors, administrators and assigns, hereby forever release, discharge and hold harmless Ontario University Athletics and its membership, representatives and agents for any injury, loss or damage to person or property howsoever caused, arising out of or in connection with ______________________________ (name of participant) taking part in soccer activities and not withstanding that the same may have been contributed to or occasioned by the negligence of Ontario University Athletics and its membership representatives or agents.

I am fully aware that thee is a risk of injury involves in participating in this type of activity.

PHOTO AUTHORIZATION AND RELEASE

I_______________________________________________, of___________________, Ontario, Canada, in consideration of

_______________________________________(my child)’s engagement as a model, authorize Ontario University Athletics (the ‘Photographer/ Videographer’), to use:

1. Digital photographs or digital videos of my child (the ‘Materials’) in accordance with the following terms:

THEME OF MATERIALS

The Materials will be recorded and used with the understanding that the content or

theme thereof will be the following: Photographs or Videos for OUA's Final Four’s marketing collateral, which may consist of but is not limited too; OUA/ Final Four commercials, online promotional material and physical copies in coaches manual or player packages. The material may be used in, through and past the existence of the Final Four tournament.

LOCATION

The Materials will be recorded at or around the following location(s): Tim Horton’s Field, Hamilton, Ont

SCHEDULE

The approximate time during which the Materials will be recorded is: November 1, 2014-November 2, 2014

REPRODUCTION AND USE

Ontario University Athletics has the unrestricted right and permission to copyright and use, re-use, publish, and republish the Materials in all forms of media (including printed materials) for art, promotional purposes (including, but not limited to, advertising, publicity, commercial, or display use), illustration, exhibition, editorial, trade, or any other purpose whatsoever. This right extends to both domestic and foreign markets.

RELEASE OF CLAIMS

I hereby relinquish any right that I may have to examine or approve the completed

Materials or their use(s). Further, I hereby release and discharge Ontario University Athletics and all persons functioning under their permission or authority (including, but not limited to, associates, affiliates, officers, agents, advertising agencies, designated directors, employees, and customers) from any claims. This includes claims related to blurring, alteration, distortion, or use in composite form that may occur or be produced in the process of recording, processing, or publishing the Materials, including any claims for libel or invasion of privacy.

I have read the foregoing and fully understand the contents hereof. I represent that I am the parent or legal guardian of the above named model. I further acknowledge that participation is voluntary and that neither I, the minor child, or minor children will receive financial compensation of any type associated with the taking or publication of these photographs/ videos or participation in OUA/ Affiliates marketing materials or other publications.

* required field