2005 Individual Registration Form (click for Team Registration Form)

I understand the Concordia College camp director and instructors will not be held responsible for injuries or loss of property while my child is attending the Tournament. By my signature below, I hereby release Concordia College, its officers, agents, and employees from any and all liability, including claims and suits in law or equity, for any injury, fatal or otherwise, or the loss of personal property, and will indemnify and hold harmless Concordia College, its officers, agents, and employees from any such claims. I realize the risks involved to the student, including the risks inherit to the sport of football. I will pay, or cover through my insurance, any medical or hospital expenses, doctor bills, or other expenses that could be incurred as a result of treatment given to my child for illness or injurywhile attending the Tournament. I hereby authorize the staff of the Concordia College Tournament to act for me according to their best judgement in any emergency requiring medical attention. I further understand the Tournament retains the right to use, for publicity and advertising purposes, photographs of participants taken in the tournament.

PLEASE PRINT CLEARLY

Name of Player______________________________________________________

Address____________________________________________________________

Name of Parent or Guardian_____________________________________________

Daytime Phone_______________________________________________________

City/State/Zip________________________________________________________

Medical Insurance Company (required)_____________________________________

Policy Number (required)_______________________________________________

Parent or Guardian Signature____________________________________________

Date________________________________________
 

Camp Director - Scott Lucier
Call 218-299-4427 or email: lucier@cord.edu

This page is maintained by the Concordia Sports Information Office sid@cord.edu
 

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