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Wizards + Mystics Camps & Clinics Registration

Online Registration
Please fill out the form below to register online. After registering you will be redirected to Ticketmaster where you will be able to pay for Wizards + Mystics Camp. Please note that nothing will be mailed to the address provided on the registration page. You will receive a confirmation & follow up email with detailed camp information.

If your child is participating in multiple camp sessions or if you have multiple children participating, please fill out this printable form instead to receive $10 off the second registration. You must fill out and mail this form in order to receive your multiple camper/sibling discount.

REGISTRATION FORM
Participant Information
First Name:
Last Name:
School You Attend:
Grade Level:
Gender: (M/F)
Jersey Size: (S, M, L, XL)
Age:
Date of Birth (mm/dd/yy):
Camp You Are Attending:
Emergency Contact/Medical Information
Parent/Guardian Name:
Parent/Guardian Phone #:
Parent/Guardian Secondary Phone #:
Parent/Guardian Email:
Parent/Guardian Address:
City:
State:
Zip (5-digit):
Wizards Planholder Acct. #:
Medical Insurance Company:
Medical Insurance Number:
Medical Notes/Comments:
Does camper have any condition (e.g., mental, physical, emotional) either identified above or otherwise which might affect their health or well-being, the well-being of others, or affect their ability to engage in camp activities? If so, please describe.
Are there any limitations on camper's ability to participate in any camp activities? If so, please describe (including any adaptations or modifications appropriate or necessary).
How do you hear about the Camps & Clinics programs?
RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
IN CONSIDERATION of the listed registrant's being accepted for the 2012 Washington Wizards & Mystics Basketball programs, Washington Wizards Dance and Cheer programs and activities (the "Programs"), I, for myself and the registrant, for which I am parent and/or legal guardian, and my assigns, heirs, and next of kin:

1. ACKNOWLEDGE, agree and represent that my son/daughter (the "registrants") has received a physical examination by a physician and has been found to be capable of participating in the Programs. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with the medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of each assistance and/or treatment.

2. FULLY UNDERSTAND that: (a) basketball involves risks and dangers of serious bodily injury, including permanent disability, paralysis, and death ("Risks"); (b) these Risks and dangers may be caused by my registrant's actions or inactions, the actions or inactions of others participating in the Programs, the condition in which the Program takes place, or the negligence of the "Releasees" named below; and (c) there may be other risks and social economic losses either not known to me or not readily foreseeable at the time. I hereby accept and assume all such risks and all responsibility for losses, costs, and damages incurred as a result of my registrant's participation in the Programs.

3. HEREBY RELEASE, discharge and covenant not sue the National Basketball Association, the Women's National Basketball Association, Lincoln Holdings LLC, Monumental Sports & Entertainment , DC Arena LP, Verizon Center, the Washington Bullets LP dba Washington Wizards, the Washington Mystics, all other professional and non-professional basketball leagues, coaches, players, trainers or personnel involved in sponsoring the Programs, the managers of the Programs and their respective affiliates and all of their respective administrators, directors, agents, officers, members, volunteers and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Programs take place (each considered one of the "Releasees" herein) from any and all liability, claims, demands, losses, or damages on my or the registrant's account caused or alleged to be caused in whole or in part by the negligence of the "Releasees" or otherwise, including negligent rescue or operations; and I further agree that if, despite this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement, or anyone on my or the registrant's behalf, makes a claim against any of the "Releasees," I will defend, indemnify, save and hold harmless each of the "Releasees," from any and all litigation expenses, attorney fees, losses, liabilities, damages, or costs which may incur as a result of such claim.

4. HEREBY GRANT the Washington Wizards and the Washington Mystics the right to use images of my son/daughter in the future marketing and/or promotion of the Programs, or the Washington Wizards and Washington Mystics generally through the use of his or her image or likeness in all promotional materials and internet initiatives, including flyers, brochures, and online.

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance notwithstanding, shall continue in full force and effect.

Parent/Guardian Full Name: Date: (MM/DD/YY)

Registration is not complete! Please note that after clicking the submit button you will be automatically redirected to a secured Ticketmaster page to submit your payment method and complete your registration. We cannot reserve your space in the camp without payment and a completed registration application. Nothing will be mailed to the address provided on this page. You will receive a confirmation & follow up email with camp information.

If your child is participating in multiple camp sessions or if you have multiple children participating in one camp session please fill out this printable form instead to receive $10 off the second registration. You must fill out and mail this form in order to receive your multiple camper/sibling discount.


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