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Use the form on the right to contact us.

You can edit the text in this area, and change where the contact form on the right submits to, by entering edit mode using the modes on the bottom right.

 
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 ©2013 US Collegiate Development LLC. The shield logo and Jakl logo are trademarks of US Collegiate Development LLC.

9 Reservoir Road
Hanover, NH 03755
USA

(321) 480-3429

Medical Release

 

I hereby grant permission for myself and/or my child (“Participant”) to participate in all practice sessions, camps, and other activities involving US Collegiate Development LLC. Permission extends to any travel to and from any and all practice sessions, camps, and other activities sponsored and arranged by US Collegiate Development LLC. This permission is granted without reservation. Recognizing the risks presented by the competitive contact sport of rugby, the signature below indicates a knowing, voluntary release of any claim that might be asserted against US Collegiate Development LLC, its officers, administrative assistants, coaches, assistant coaches, managers, sponsors, chaperons, designated drivers, volunteers, and any other agents representing US Collegiate Development LLC. By waiving any right to assert a claim, I am agreeing to release, absolve, indemnify and hold harmless any and all parties previously mentioned for any and all liability arising from any injuries incurred by Participant.

I, the Participant and/or the Participant’s legal parent or legal guardian, accept and assume all risks and hazards inherent in and related to the activities of US Collegiate Development LLC, including any travel and from any activities sponsored and arranged by US Collegiate Development LLC. This permission also includes my authorization for emergency medical treatment deemed appropriate and necessary by any coach, assistant coach or representative or agent thereof for participant, including transport to the nearest medical facility adequate to treat the emergency.

I verify that my child had been checked by a licensed physician prior to coming to the US Collegiate Development camp/clinic and is physically able to participate fully. I agree to allow my child to be treated by a licensed trainer and/or physician while attending camp. In addition, I assume all risks resulting from the participation in this sports camp/clinic and will hold harmless Dartmouth College of any and all liability actions, causes of action, claims and demands of every kind and nature whatsoever which may arise in connection with or resulting from participation in any of its activities.