Youth Bootcamp (ages 7 and up)

* Childs Name (First and Last):
 
* Age as of September 6, 2017:
 
* Parent/Guardian's Name:
 
* Parent will be participating in a Fit Fair event?
 
* Family Email:
 
* Emergency Contact:
 
* Relationship:
 
* Emergency Phone Number:
 
Special Accommodations Needed:
If registering prior to or on 8/28/17, please select a t-shirt size (please note Adult and Youth sizes! Choose one.)
Please check the box next to each section below indicating that you have read and give parental permission for each section.
* Photo Release Form

I understand the ND National Guard (NDNG)/Bismarck State College (BSC) are developing photographic and multimedia materials, which will illustrate events occurring throughout the year for the promotion of events. I grant the NDNG and BSC and its associated staff and subordinate entities the right to take, use, reproduce, assign and/or distribute photographs, films, non-confidential information, videotapes and sound recordings of the NDNG and BSC or its associated entities may create, without payment to or future approval by me. I concur that there shall be no payment for such use.
 
 
* Parent's/Guardian's Agreement of Waiver of Liability, Indemnification, and Medical Release
To be signed by parent/legal guardian if the participant is under 18 years of age.

Acknowledgement and Assumption of Risk
The undersigned parent and/or legal guardian does hereby acknowledge that he/she is aware of the dangers and the risks to the participant's person and property involved in participating in an event sponsored by the ND Army National Guard (NDARNG) and Bismarck State College (BSC).
Nevertheless, the undersigned parent and/or legal guardian acknowledges that the participant voluntarily elects to participate in this activity with knowledge of the danger involved, and the undersigned parent and/or legal guardian hereby agrees to accept and assume any and all risks of property damage, personal injury, or death.

Waiver of Liability, Indemnification, and Medical Release
In consideration for being allowed to voluntarily participate in the above-referenced event, on behalf of the participant, his/her personal representatives, heirs, next of kin, successors and assigns, the undersigned parent and/or legal guardian forever:
          a. Waives, releases, and discharges the NDNG, BSC, the State of North Dakota and the United States and their agencies, officers, and employees from any and all liability for the participant's death, disability, personal injury, property damages, property theft, or claims of any nature which may hereafter accrue to the participant or the participant's estate as a direct or indirect result of participation in the NDNG sponsored event.
          b.Indemnifies, saves, and holds harmless the NDNG, BSC, the State of North Dakota, and the United States and their agencies, officers, and employees from and against any and all claims of any nature including costs, expenses, and fees arising out of or resulting from participant's actions during the NDNG/BSC sponsored event.

Consent is given for the participant to receive medical treatment, which may be deemed advisable in the event of injury, accident or illness during a NDARNG/BSC sponsored event. This release, indemnification, and waiver shall be construed broadly to provide a release, indemnification, and waiver to the maximum extent permissible under applicable law.

I, the undersigned parent and/or legal guardian, affirm that I am at least 18 years of age and am freely signing this Agreement. I have read this form and fully understand that by signing this form I am giving up legal right and/or remedies which may otherwise be available to the minor participant regarding any losses the participant may sustain as a result of his/her participation. I agree that if any portion is held invalid, the remainder will continue in full legal force and effect.

 
 
For questions, please contact the NDARNG

Erin DeMoe or Cathy Palczewski
North Dakota Army National Guard Substance Abuse Program
701-333-3266 or 701-333-3265
erin.n.demoe.ctr@mail.mil or cathy.s.palczewski.ctr@mail.mil
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