(insert childs name entered in fill in below) is physically fit to participate in the activities of the Nashoba Boys Soccer Clinic. In the event of any medical emergency where representatives of the camp are unable to contact a parent or guardian of the above participant, I authorize the camp personnel to act in my child’s best interest and render any necessary treatment, including hospitalization if necessary. I understand that the Nashoba Boys Soccer Clinic does not provide medical insurance for participants. In consideration for the athlete’s participation in and enjoyment of the Clinic, instruction and facilities, I waive, release and forever discharge the camp, its coaches,directors, agents, promoters, and employees, Nashoba Regional HS and the town of Bolton, its officers, directors,agents, promoters, and employees from any responsibility from any and all liability, claim, loss, rights of action, or for accidents and medical or dental expenses present or future, anticipated or unanticipated, resulting from or arising out of or in incident to participation in this clinic. I waive and release Nashoba Boys Soccer Clinic and the town of Bolton and Nashoba Regional HS from any responsibility for possessions lost or damaged by weather, water, fire, theft or personal negligence or any injury or illness incurred while at the clinic or traveling to and from any clinic activity. (in the space below please enter your childs first and last name) *
