Davis mountains fitness & training camp registration form

Davis Mountains Fitness & Training Camp
August 4 – 10, 2013
Each camper must complete all three pages of this form and mail with a $100 non-refundable, non-transferable deposit to: Davis Mountains Fitness and Training Camps, Inc., Post Office Box 13311, Austin, TX 78711 *email registration questions to Allegra Frolow at registrar@fitnesscamp.org*
Personal Information
First Name for Camp Badge (if different from above):
Accommodations, Shirt & Camper Roster
Rates are per-person and include lodging, meals and activities. If you were a 2012 camper, would you like the same cabin you were assigned last year (yes or no): If you answered “yes”, please list your cabin and roommate(s) for 2013: If you answered “no”, or if you are a new camper, please circle your prefered housing assignment below. Ranch Cabin
Hilltop Cabin
Group Cabin
group of 3 or more, you will be assigned Cabins fill up quickly. Please describe your second choice housing assignment: A shirt is included with registration. Please select the style and size you would like. Style and size not guaranteed after July 1, 2013. Style: Mens Womens Size: Small Medium Large XLarge XXLarge (Mens Only)

I would like my name, city, state, phone number and email address published in the camper roster: Yes No

Registration and Cancellation Policy
$100 DEPOSIT IS DUE WITH REGISTRATION FORM. Your deposit is non-refundable, non-transferable. BALANCE IS DUE IN
FULL BY JUNE 1, 2013. You will receive an invoice via email upon receipt of registration. Please mail your balance to the post
office box listed above. Ensure your final payment is postmarked by June 1, 2013 to avoid forfeiture of your deposit and cabin.
I understand and accept the Registration and Cancellation Policy. Davis Mountains Fitness & Training Camp
August 4 – 10, 2013
Acknowledgment of Fitness Camper Responsibility,
Express Assumption of Risk and Release of Liability
In consideration for the payment of the fees for and my acceptance as a participant at the Davis Mountains Fitness & Training Camp (“DMFTC”) OR The Prude Ranch Races, and the services, activities and amenities to be provided by DMFTC in connection with the Camp, I confirm my understanding of the following. 1. I may be exposed to a variety of hazards and risks, foreseen or unforeseen, which are inherent in attending and participating in activities and events at DMFTC and cannot be eliminated without destroying the unique character of the DMFTC. These inherent risks include, but are not limited to, the dangers of serious personal injury, property damage, and death (Injuries and Damages). 2. I understand that Injuries and Damages can occur by natural causes or activities of other persons, animals, trip members, trip leaders and assistants or other third parties, either as a result of negligence or because of other reasons. I understand that risk of such Injuries and Damages are involved in participating in a camp such as the DMFTC and I appreciate that I am responsible for myself and may have to exercise extra care for my own person and for others around me in the face of such hazards. 3. I further understand that there may not be rescue or medical facilities or expertise necessary to deal with the Injuries and 4. I have read any rules and conditions applicable to the Camp made available to me and I will pay any costs and fees for 5. I acknowledge that my participation in any activity is at the discretion of the leader(s). 6. The DMFTC officially begins and ends at the location(s) and at the times designated by the DMFTC. It does not include carpooling, transportation or transit to and from the DMFTC location, and I am personally responsible for all risks associated with this travel. 7. If I decide to leave early and not to complete the DMFTC as planned, I assume all risks inherent in that decision to leave and waive all liability against the DMFTC arising from that decision. 8. If at any time any one of the leaders has concluded a DMFTC activity, and I decide to go forward without the leader, I assume all risks inherent in that decision to go forward and waive any and all liability against the DMFTC arising from that decision. 9. This Waiver is intended to be as broad and inclusive as is permitted by Texas law. This Waiver is to be construed under the laws of the State of Texas and the venue of any action relating to this Waiver is to be held in the State courts in Austin, Travis County, Texas. If any provision or any part of any provision of this Waiver is held to be invalid or legally unenforceable for any reason, the remainder of this Waiver shall not be affected thereby and shall remain valid and fully enforceable. 10. I have read, I understand and I agree to the DMFTC Registration and Cancellation Policy. 11. I hereby authorize the reproduction, sale, copyright, exhibition, broadcast and/or distribution of any event videotape or THEREFORE, to the fullest extent allowed by law, I agree to WAIVE, DISCHARGE CLAIMS, AND RELEASE
FROM LIABILITY, DMFTC, Inc. its officers, directors, employees, agents and leaders from any and all liability on
account of, or in any way resulting from Injuries and Damages, even if caused by the negligence of DMFTC, its officers,
directors, employees, agents and leaders, in any way connected with the DMFTC.
I FURTHER agree to HOLD HARMLESS DMFTC, its officers, directors, employees, agents and leaders from any claims,
damages, injuries or losses caused by my own negligence while a participant at the DMFTC. I understand and intend that this
assumption of risk and release is binding upon my heirs, executors, administrators and assigns, and includes any minors
accompanying me to the DMFTC.
I have read this document in its entirety, and I freely and voluntarily assume all risks of such Injuries and Damages
and notwithstanding such risks, I agree to participate in the DMFTC.
I further certify that I am physically fit to participate in this DMFTC or event. This entry (or participation) is invalid
unless signed by participant. I certify that I am 18 years of age or older and if participant is under 18 years of age,
parent or legal guardian must sign below.
Name
Davis Mountains Fitness & Training Camp
August 4 – 10, 2013
Medical Information
Name:
Date of Birth:
Current Medical Issues:
Other Health Concerns/Risks:
Current Prescribed and Other Medications/Supplements:
Allergies
Past/Current/Surgical Treatments:
Primary Doctor
Medical/Health/Health Risk Topics of Interest to You (for possible camp discussions):
Dietary Restrictions:

Source: http://fitnesscamp.org/2013_Registration_Form.pdf