McKinnley Jackson Youth Football Camp

Camper Full Name

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Last

Camper Age

Grade Entering in Fall of 2026

Name of School

T-Shirt Size

Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in the case of an emergency.

Parent / Guardian Name

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Parent / Guardian Email

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Address

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Terms and Agreement

In consideration for my child being able to participate in the McKinnley Jackson Football Camp (“Camp”) on or about July 11, 2026, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the undersigned, as parent or legal guardian of the Camper identified above (the “Camper”), hereby grants the permission necessary to allow the Camper to participate in the Camp. The undersigned, on my own behalf and on behalf of the Camper: (a)acknowledges that the risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) to the Camper from the activities involved in the Camp are significant, and while particular guidelines implemented by Camp, may reduce these risks, the risks of serious injury and illness do exist; (b) willingly, expressly and voluntarily assume all risks of illness and injury sustained by the Camper while participating at the Camp; (c) agrees, to the fullest extent under law, to release and discharge and to hold harmless the Camp, McKinnley Jackson, the volunteers, the coaches, the sponsors, the promoters, Legend Agency LLC (“Legend”), the Camp site location on whose premises the Camp will occur, and each of their respective affiliates, directors, officers, shareholders, members, representatives, agents, and employees (collectively “Releasees”) from any and all liability, whether caused by the negligence of the Releasees or otherwise for any claim, judgment, loss, liability, cost and expenses (including, without limitation, attorneys’ fees) arising of or connected with the Camp, including any claim arising out of or connected with any illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19, or injury that the Camper may incur or sustain during the Camp and all activities associated with the Camp; and (d) agrees, to the fullest extent under law, to indemnify and hold harmless Releasees and Releasees’ successors and assigns against loss from any claims, demands, damages, or actions that may be brought by the undersigned or the Camper or by any other persons on account of damages of any character resulting to the Camper in any way from the foregoing activities. The undersigned understands that Camp, Legend, its sponsors, representatives, agents, and employees, from time to time produce promotional and/or content material relating to the Camp. I understand that as a participant in and/or spectator at the Camp, the Camper may be included in videotapes, photographs, DVD’s, podcasts, audio recordings, other media (including social media and other internet media) and the like taken during the Camp. Without reservation or limitation, the undersigned, on my own behalf and on behalf of the Camper, hereby assign, transfer, and grant at no charge, to the Camp, Legend, and its successors, assigns, licensees, sponsors, television networks, radio stations, and all other commercial exhibitors, the right to photograph and/or video or record the Camper and to utilize any film and footage from the Camp of the Camper’s name, face, likeness, voice and appearance in advertising and promoting the Camp. The undersigned warrants that: (a) the Camper is physically fit to participate in the Camp; and (b) the undersigned will not allow the Camper to participate in the Camp if the undersigned has any concerns about the Camper’s overall health, fitness, or medical condition. If the undersigned has any concerns for the Camper’s health, the undersigned will remove the Camper from the Camp. In the event the Camper suffers an illness or injury during the Camp, the undersigned authorizes any Camp representative to obtain necessary medical treatment for the Camper and hereby, in my own behalf and on behalf of the Camper, release and hold harmless the Releasees in the exercise of this authority. The undersigned further acknowledges and understands that the undersigned will be responsible for any and all medical and related bills that may be incurred for any illness or injury. The undersigned, on my own behalf and on behalf of the Camper, warrant that: (a) I am authorized as the guardian of the Camper, and in sound mind, to sign this Waiver and Release. (b) I have read this Waiver and Release in its entirety and fully understand its contents; (c) I am aware that this Waiver and Release Form releases the Releasees from liability and I am giving up my right and the Camper’s right to bring a legal action against the Releasees; (d) I am aware that this Registration Form contains an acknowledgement of my voluntary and knowing assumption of the risk of injury or illness; and (e) I have signed this document voluntarily and of my own free will. This document is governed by and shall be construed under the laws of the State of New Jersey. By signing below, I acknowledge that I have read, understand and agree to the terms outlined above: I have read and agree to all terms and conditions included in this agreement. I PERSONALLY AND ON BEHALF OF THE CHILD I AM THE GUARDIAN OF ASSUME ANY AND ALL RISK THAT IS ANYWAY ASSOCIATED WITH, RELATED TO OR OCCURS AS A RESULT OF PARTICIPATION IN THIS CAMP AND FULLY AM AWARE THAT THIS AGREEMENT WAIVES RELEASEES FROM LIABILITY.

Print Name of the Parent / Guardian of the Camper

Signature of Parent / Guardian of the Camper

Clear Signature

the Camper Camper

This camp signup will only be considered complete with signature from the Parent / Guardian.

Saturday, July 11, 2026 10am-12:30pm | Ages 6-13

George County HS | 9284 Highway 63 South | Lucedale, MS 39452

Stadium is behind the school

Emergency Contact Information

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