| Camper Info | |
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| Camper first name | Kyah |
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| Camper last name | Berry |
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| Camper Date of Birth | 19/12/2008 |
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| Camper grade in fall 2025 | 11th |
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| Shirt size | Adult Small |
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| Camper Insurance Carrier and Policy # | OHP YL700W6L |
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| Parent/Guardian Info | |
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| First name | Stephanie |
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| Last name | Berry |
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| Phone | (541) 531-6792 |
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| Alt Phone | (541) 531-6791 |
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| Email | Email hidden; Javascript is required. |
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| Camp Releases (Camper) | |
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| I, the undersigned, hereby acknowledge and understand that participation in the Volleyball Camp involves physical activity and carries inherent risks, including but not limited to, physical injury, accident, pain, suffering, illness, disfigurement, temporary or permanent disability, and death, which may arise from the actions or inactions of myself, other participants, spectators, coaches and/or organizers. These risks include, but are not limited to, slips, falls, physical exertion, collisions, crashes, projectiles, accidents, terrain, facilities, equipment, temperature, weather, lack of hydration, condition or acts of participants and coaches, and other unpredictable occurrences. I voluntarily choose to participate in the Volleyball Camp, fully understanding these risks, and I expressly assume all risks associated with my participation. I am in appropriate physical condition to participate in the Volleyball Camp. | - As the camp participant, I agree to the above statement.
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| In consideration for being allowed to participate in the Volleyball Camp, I hereby release, waive, discharge, and hold harmless All American Volleyball Camps, their officers, directors, members, contractors, coaches, employees, volunteers, agents, and all others involved in the planning or operation of the Volleyball Camp (collectively, the "Released Parties") from and against any and all claims, demands, actions, or causes of action arising out of or related to any injury, accident, death, or damage that I may suffer as a result of my participation in the Volleyball Camp, even if caused by the negligence or intentional acts of the Released Parties. This waiver applies to all claims, whether they arise from my own actions or from the actions of others, including those related to physical injury (including death), property damage, or any other incident that may arise during or as a result of the Volleyball Camp. | - As the camp participant, I agree to the above statement.
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| I agree to indemnify, defend, and hold harmless the Released Parties from any and all claims, demands, actions, or causes of action arising out of my participation in the Volleyball Camp, including any costs, expenses, or attorney fees incurred by the Released Parties in connection with such claims. This indemnification applies to claims arising from my own actions or negligence, or those of any third parties arising out of or in connection with the Volleyball Camp. | - As the camp participant, I agree to the above statement.
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| In the event of an emergency, I hereby authorize All American Volleyball Camps or their representatives to seek medical treatment for me if I am injured or require medical assistance during the Volleyball Camp. I understand that I am responsible for any medical expenses incurred as a result of such treatment. | - As the camp participant, I agree to the above statement.
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| By electronically signing this form, I acknowledge that I have read, understood, and voluntarily agree to the terms outlined above. | Kyah Berry |
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| Camp release (Parent/Legal Guardian) | IF PARTICIPANT IS UNDER 18, THIS CERTIFICATION MUST BE SIGNED BY HIS/HER PARENT/LEGAL GUARDIAN
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| I hereby certify that I am the parent or guardian of the above camper, and do hereby give my consent without reservation to the foregoing on behalf of this individual. I have read and understand the terms of this Assumption of Risk, Waiver, and Indemnification Agreement. I will act as indemnitor of Released Parties as set forth above. I understand the risks associated with the Activity and even so am permitting the above camper to engage in the Activity. | - As the parent or legal guardian, I agree to the above statement.
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| By electronically signing this form, I acknowledge that I have read, understood, and voluntarily agree to the terms outlined above. | Stephanie Berry |
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| Payment | |
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| Date | 07/26/2025 |
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| Sport | VB |
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| Camp Fee | 192 ($192.00) |
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| Total | $192.00 |
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| Credit Card | Visa
XXXXXXXXXXXX4029 |
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