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Winter Warm-Up Lacrosse Clinic - 2007 |
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When: Friday, Dec. 14th 6:00-9:00p.m.,
Saturday December 15th, 12:00-4:00pm, Sunday December 16th,
11:00am-1:00pm
Where: University City Centennial Commons 7210 Olive Blvd, University City, MO 63130 What: The Ante-Up staff leads students though a comprehensive, collegiate level off-season workout plan. Our goal is for players to enhance their skills while seeing what it takes to compete on the next level. Workouts include:
Following camp, students receive a packet of winter drills and workouts to use for the upcoming season Instructors: Chris Panos- Team USA, Chicago Shamrox NLL, Hofstra University Ben O’Neill-Johns Hopkins University, 2 time National Champion ’05,’07 Nick Silva- Manhattan College, Fontbonne University Head Coach Ryan Carter-Butler University, Fontbonne University Assistant Coach Tim Duffy- Ohio State University, European games Gold Medalist Kyle Miller- Johns Hopkins University, 2 time National Champion ’05,’07 Plus additional area Samurai and Brave lacrosse coaches; Ante-Up maintains a strict 8:1 camper to staff ratio. Cost: $225 (Ages 14-18) checks payable to Ante-Up Lacrosse, registration forms- Pg. 3 includes jersey, take-home winter workout program, and entry in Camp Raffle. Questions, email rcarter@anteuplacrosse.com or call 517-420-6231 Athletic Waiver and Release of Liability This document must be read, signed and received prior to camper’s participation. Submit this completed waiver with your mailed-in application or when you check in at camp. Camper’s Name: Camp Attending: Chicago, IL June 11-14 Louisville, KT June 21-24 Chicago, IL July 7-8 Madison, WI July 12-15 St. Louis, MO Dec 14th-16th WINTER WARM UP In consideration of being allowed to participate in any way in the Ante-Up Lacrosse athletic sports programs, related events and activities, the undersigned acknowledges, appreciates and agrees that: 1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation: and, 3. I willingly agree to comply with the stated customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and will immediately bring such hazard(s) to the attention of the nearest official: and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS, Ante-Up Lacrosse, Inc. their officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of the premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY , DEATH, or less damage to person or property, WHETER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF THE RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSUTNTUAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT. _________________________________________________________________________ __________________________________________ Participant’s Signature Date _____________________________________________________________________________________________________________________ For Participants of Minority Age (Under 18 at the time of registration) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE. _________________________________________________________________________ __________________________________________ Parent / Guardian Signature Date _________________________________________________________________________ Print Name Registration Ante-Up Lacrosse 3224 Locust St. Ste. 203 St. Louis, MO 63103 NAME______________________________AGE_________ ADDRESS________________________________________ CITY__________________________STATE____________ PHONE ( )_____________________________________ E-MAIL ADRESS__________________________________ POSITION:_______________________________________ YEARS OF EXPERIENCE__________________________ SHIRT SIZE______________________________________ Emergency Contact NAME_____________________________________________ ADDRESS__________________________________________ CITY___________________________STATE_____________ PHONE ( )______________________________________ CELL PHONE ( )________________________________ Mail completed registration form and Fee to: Ante Up Lacrosse 3224 Locust St. Ste. 203 St. Louis, MO 63103 www.anteuplacrosse.com
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