TPHS Foundation
2019 Pole Vault Camp Registration

Improve your 
TECHNIQUE, SPEED, and STRENGTH
this summer at the
 
Del Mar Track Club
 
Pole Vault Camp
 
When?
Mondays 4:00 - 7:00 PM & Wednesdays 2:00 - 5:00 PM

Where?
Torrey Pines High School Stadium
 
How Much?
$200
 
How?
 
1) Register for a USATF membership for the year 2018-2019 (www.usatf.org), $20 fee.  When registering for the first time, please enter our USATF club number which is: 44-0173.  Membership is good til the end of August.
 
2) Registered online for the Pole Vault Camp at: www.torreypinesfoundation.org/registere-for-events/ - you will need your USATF (www.usatf.org) membership to register for camp.
 
3) Pay $200 to TPHS Foundation for stadium use and insurance.
 
Questions?
 
Contact: Kyle Goodenough, kyle.goodenough@yahoo.com

PARTICIPANT HEALTH INFORMATION & PARENT RELEASE AND WAIVER

Participant Information

Please submit ONE form per participant. Thank you.

Parent / Guardian Information

Relationship to Participant: *
 

Health & Insurance Information

Please list all physical or emotional limitation(s) your child may have: *
 

By checking this box I confirm that the participant is covered by Health Insurance. Participants must have Health Insurance to participate in this camp. Please provide Insurance Information below. *

USATF Insurance Information

By checking this box I confirm that the participant is covered by USATF Insurance. Participants must have USATF Insurance to participate in this camp. Please provide USATF Insurance Information below. Please use www.usatf.org to register. *

TPHSF Parent Release and Waiver

As the parents or legal guardian of the child (Participant) named below, I hereby give my full consent and approval for my child to participate in the camp, clinic, workout or tournament of the Torrey Pines High School Foundation. I authorize the Torrey Pines High School Foundation to use any photograph or article about my child for publicity purposes. I understand that violation of camp, clinic, workout or tournament rules may result in dismissal from the camp, clinic, workout or tournament with all fees/tuition forfeited. Additionally, I/We have read, understand and agree to the Torrey Pines High School Foundation refund policy.

I/We understand that the Torrey Pines High School Foundation carries the Group Accident Insurance Coverage for medical and hospital expenses, with a given deductible and a specified maximum for each accident incurred. The camp, clinic, workout or tournament is considered as secondary, when there is a valid collectable coverage provided by the parents separate insurance. In executing the foregoing I/We undersigned hereby acknowledge and represent that: (A.) I/We, understand that any claim for medical service which arises out of injury must be reported to the event insurance administrator, immediately and within THREE (3) DAYS of the date of injury; (B) I/We have read the foregoing release and understand it, and sign it voluntarily. I/We understand that my Registration Fee or other sum paid does not constitute payment for insurance.

In the event of an emergency in which my child requires medical care, I authorize the staff of Torrey Pines High School Foundation’s activity to act for me and to obtain for him/her whatever medical treatment the staff, in its best judgment, deems necessary and appropriate. I specifically consent to such treatment, but not limited to, hospitalization and surgery and will be responsible for any medical or other charges in connection with his/her attendance at the camp, clinic, workout or tournament.

I understand that there are certain risks of injury inherent in participating in the camp, clinic, workout or tournament sessions, as well in traveling and other activities incidental to my child’s participation in same and that my child is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as listed above. I further acknowledge that my child will be participating in activities that may involve, among other things physical contact of the body with other persons or objects including the ground, that at the camp my child may incur a risk of injury. I specifically waive and release Torrey Pines High School Foundation, Torrey Pines High School and San Dieguito Union High School District, their lessors, sponsors, directors and staff from any liability for any claim for damages which I/We or my child may have for injuries or illness that he or she may sustain, whether the result of gross negligence or any other causes.

Waiver of California Civil Code S1542.
In furtherance of the foregoing releases, the parties expressly waive any and all rights and benefits conferred upon them by the provisions of Section 1542 of the California Civil Code, which provides: “A General Release does not exceed to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor.” The settling parties each acknowledge that they have discussed with their attorneys the significance and effect of waiving the provisions of Section 1542 of the California Civil Code, and warrant that this waiver is informed, knowing and voluntary.

Agreement to TPHSF Parent Release and Waiver

By clicking this box you confirm that you have read and agree to all terms in the above TPHSF Parent Release and Waiver. *

AGREEMENT TO PARTICIPANT HEALTH INFORMATION & PARENT CONSENT AND WAIVER

By clicking this box you confirm that all the information provided in the above PARTICIPANT HEALTH INFORMATION & PARENT RELEASE & WAIVER is accurate to the fullest extent. *

Agreement to Electronic Consent

By clicking this box you confirm the use of electronic communication as your form of consent *
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