Students will be released to primary and secondary contacts. Please add any additional authorized drivers in this field.

As the parent and/or legal guardian of the participant stated above, I have given my child permission to participate in the LCHS Basketball Camp July 7-10, 2025, and I certify that he/she/they is/are in good health and can take part in all camp activities. I fully understand that participation in the   LCHS Basketball Camp July 7-10, 2025 may involve serious risks and danger that may result in harm, bodily injury and death. While particular rules, equipment, and personal discipline may reduce the risk, I acknowledge the risk of serious injury does exist. In the event of an emergency or an injury occurs, I authorize the camp staff members to take all proper action and use the emergency service available at the nearest hospital if necessary. I understand my personal insurance will be used in this case. I, for myself and on behalf of the participant hereby release and hold harmless against any claims, damages, and expenses Loudoun County Athletic Booster Club, Kara Griffin, Kim Norton and any of their directors, officials, agents, volunteers and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of the premises used to conduct the event. I acknowledge and agree that LCHS Basketball Camp and Loudoun County Athletic Booster Club retain the right to use photographs and videos taken of the event participants for publicity and advertising purposes. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENTS.