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EXACT Sport LLC ("EXACT") will not administer medications to event participants of any age. EXACT will not be held responsible for housing/storing medication(s). Parent(s)/Legal Guardian(s) and event participants will be held responsible for administering and housing/storing medication(s) in a discrete place during the event and/or relying on certified medical practitioners as needed.
I consent to the above
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As of this date, has the athlete received all immunizations required under state law? Please contact your family's medical professional practitioner to determine the vaccinations and immunizations appropropriate. Athletes who do not comply will not be allowed to participate in the event.
Athlete is fully immunized
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EXACT puts in place preventative measures to reduce the spread of COVID-19; however, EXACT cannot guarantee that you or
your child(ren) will not become infected with COVID-19. Further, attending an EXACT event could increase your risk and
your child(ren)’s risk of contracting COVID-19. By participating in this event, I acknowledge the contagious nature of
COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19.
I consent to the above
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My child has permission to engage in all prescribed event activities. The information provided on this form is accurate to the best of my knowledge. I have indicated any special health conditions, including required medication and activity limitations which should be known to the event staff and medical personnel. I am aware of and accept the risk inherent in the program activity. I give consent in advance for medical treatment at an appropriate facility in case of illness or injury. I agree to indemnify EXACT and its employees and agents for any claim which may hereafter be presented by our (my) son/daughter as a result of any such injuries.
I consent to the above
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I grant permission to EXACT Sport LLC, its agents, and its employees the irrevocable and unrestricted right to produce
photographs and video taken of my child, myself, and members of my family while at EXACT Camps for any lawful purpose
including distribution to college coaches, publication, promotion, illustration, advertising, trade, or historical
archive in any manner or in any medium by EXACT Sports. I hereby release EXACT Sports and its legal representatives
from liability for any violation or claims relating to said images or video. I grant permission to use the statements
of my child, myself, or my family members given during an interview or evaluation with or without my name for the
purpose of advertising and publicity without restriction to time limit or geographic area. I waive my right, my
child’s rights, and my family’s rights to any and all compensation stemming from the use of these materials.
I consent to the above
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Allergies
Does the athlete have an allergies that EXACT should be aware of (e.g. severe reaction to nuts, bee sting, etc?)
YES the athlete does
NO the athlete doesn't
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Plan of Travel
How do you plan to travel to the event (from Eastvale)?
Fly In
Drive in
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Please share an explanation of the allergy and what preventive measures you plan for the athlete's safety. This will be helpful to us to understand how we too can support the athlete.
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I, an authorized guardian of Dominic Fritzges, have filled in this form completely and accurately.
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