2020 Ohio Bobcats Basketball Team Camp Quick Sheet

- Minimum Number of Players Per team: 8

- Coaches Stipend for Resident Teams: $100 per team (We cannot issue a stipend to you if we are recruiting one of your players)

- One “Head Coach” Per Registering Team – fee of $80 for each additional coach

- Coaches will receive:

o 15+ coaching opportunities

o Coaches stipend (If resident team & if 8+ players on team)

o Room and board

o Ohio Bobcats Basketball shirt

o Coaches socials on Friday & Saturday nights

- Steps to Register

1. Fill out Coach Registration Form ASAP – mail or scan/email to:

Mike CiflikuOhio Men’s Basketball Camps1 Ohio University – Convocation CenterAthens, OH 45701mc248515@ohio.edu

2. Have players fill out Player Registration AND Medical Form and RETURN IT TO YOU

3. Mail all player forms and payments at one time to the address above

OR

Bring all player forms and payments to registration on the 1st day of camp

OHIO UNIVERSITY MENS BASKETBALL TEAM CAMP REGISTRATION COACH

REGISTRATION FORM School Coach’s Name Coach’s Home Address

City State Zip

Email Address

Coach’s Cell Phone

Please register me for Varsity Teams; JV Teams

JV Head Coach’s Name Please list additional Assistant Coaches (1 coach per team is covered. The cost for every ADDITIONAL coach is $80)

We will be operating on a first come/ first serve basis with registrations. We will have to do rooming assignments BEFORE camp this year, so a final count early is extremely important/ a necessity.

Resident Coaches ONLY- Unless I hear differently from you, I am going to be cutting the camp checks to the HEAD VARSITY Coach ONLY! This means if you bring 1 V and 1 JV team, the Head Coach will be put in for a $200 check from payroll. It will then be the responsibility of the Head Coach to divide the camp money. Please let me know if you have any further questions.

OHIO UNIVERSITY MENS BASKETBALL TEAM CAMP REGISTRATION PLAYER REGISTRATION

FORM

PLEASE CHECK ONE:

□ RESIDENT CAMPER $225.00 INCLUDES:• 2 NIGHTS IN DORMS• 3 MEALS ON SATURDAY• 1 MEAL ON SUNDAY

□ COMMUTER $150.00 INCLUDES:• DINNER ON SATURDAY

Player’s Name School Player’s Address

City State Zip

Email Address

Coach’s Name

Player’s Home Phone

Grade in school next year

Please complete the registration and medical form and TURN IT IN TO YOUR HEAD COACH, along with full payment.

Please make checks payable to Ohio Men’s Basketball Camps.

Please be sure to complete your medical form. Every camper must have a completed medical form before

participating.

OHIO UNIVERSITY SPORTS CAMP MEDICAL FORM FOR ATHLETIC PARTICIPATION

Camp Attending: TEAM CAMP Dates: JUNE 12-14, 2020

Note: This form must be presented at the time of camp registration or camper will not be permitted to participate. We are NOT requiring that each camper be examined by a physician.

SCHOOL NAME CAMPER’S NAME AGE GRADE DATE OF BIRTH ADDRESS HOME PHONE ( ) CITY STATE ZIP PARENT’S NAME BUSINESS PHONE ( ) NAME OF INSURANCE CO. POLICY HOLDER’S NAME SOCIAL SECURITY# ID# PLAN CODE # PARENT’S EMPLOYER PLEASE NOTE: Each camper must be covered by his or her own medical insurance.

1) List any major injuries in the past year pertinent to participation in competitivesports. (Use the back of this sheet if more space isneeded

2) Date of last tetanus shot3) List known allergies4) Check any known of the following conditions: DIABETES HEMOPHILIA

EPILEPSY HEART CONDITION ASTHMA5) Please list any chronic disease6) If any camper is under a physician’s care, please list the name, address andphone number of the physician and what the camper is being treated for. Also listany medication the camper will be taking during his/her stay at camp. (list alsothe strength and dosage of the medication.) Use the back of this sheet foradditional space

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AGREEMENT AND RELEASE OF LIABILITY FORM

This release executed by the Participant on behalf of _____________________ [Name of Participant] with an address at _____________________________________ (“Participant”) to Ohio University, Athens, Ohio (the “University”). The term, “Participant,” is used in this Agreement as pertaining to: (i) if Participant is of majority age, it refers only to Participant; (ii) if Participant is not of majority age, Participant refers to Participant and Participant’s Parent or Guardian. In consideration of Ohio University through its _____________ [NAME THE ORGANIZING UNIT/DEPARTMENT/COLLEGE] organizing and operating the ______________ [NAME OF THE PROGRAM/CAMP] in ______ [CITY OF APPLICABLE UNIVERSITY CAMPUS], Ohio sponsored by Ohio University on ___________, 2020, from ____ to ____ daily (“Program”) and making it available for participation by Participant and others, the Participant agrees as follows: 1. The Participant acknowledges that the Participant will participate in activities on and off of University’s _____ campus including, but not limited to: ______________________________________________________, [INCLUDE ALL ACTIVITIES THEY WILL BE DOING] swimming, participating in recreational and cardiovascular activities, traversing the University campus, dining in University facilities, etc. (“activities”) Activities involve strenuous exertions of strength using various muscle groups, some involve quick movements using speed and change of direction, some involve other participants or instructors, and others involve sustained physical activity that places stress on the cardiovascular system. The specific risks vary from one activity to another, but the risks range from: minor injuries such as scratches, bruises and sprains; to major injuries such a broken/fractured bone, eye injury or loss of sight, joint or back injuries, heart attacks, and concussions; to catastrophic injuries including paralysis and death. 2. The Participant understands and agrees that the state of Ohio, University, its governing board, employees, agents, and volunteers: (i) are not responsible or liable for any injury, damage, loss, accident, delay or other irregularity which may occur by the defect of any vehicle or building or the negligence or default of any company or person engaged in providing or performing any of the services involved in this Program; (ii) are not responsible for losses or expenses due to sickness, weather, strikes, hostilities, wars, natural disasters, or other such causes; (iii) are not providing liability insurance for vehicles and will not be responsible for any accidents, injuries, damages, etc. in the transportation to and from the Program; (iv) are not responsible for any disruption of travel arrangements, or any consequent additional expenses that may be incurred therein; (v) assume no liability whatsoever for any loss, damages, destruction or theft or the like to Participant’s luggage or personal belongings and that Participant has retained adequate insurance or has sufficient funds to replace such belongings and the Participant will hold the University harmless therefrom. 3. Knowing the dangers, hazards, and risks of such activities, and in consideration of being permitted to participate in the Program, the Participant, on behalf of Participant, Participant's family, heirs, and personal representative(s), agrees to assume all the risks and responsibilities surrounding Participant's participation in the Program, the transportation, and in any activities undertaken as an adjunct thereto, and in advance releases, forever discharges, waives, and covenants not to sue the University, its governing board, officers, agents, employees, and any students acting as employees (“the University and its Agents”), from and against any and all liability for any harm, injury, damage, claims, demands, actions, causes of action, costs, and expenses of any nature whatsoever which Participant may have or which may hereafter accrue to the Participant, arising out of or related to any loss, damage, or injury, including but not limited to suffering and death, that may be sustained by Participant or by any property belonging to Participant, whether caused by the negligence or carelessness of the University and its Agents, or otherwise, while in, on, upon, or in transit to or from the Program or any activity adjunct to the Program. The Participant hereby releases the University for any liability for any medical decisions or actions and from all medical and transportation expenses incurred on behalf of or for the benefit of Participant. 4. The Participant assures the University of Participant having consulted with a medical doctor with regard to Participant's personal medical needs such that the Participant can and does further state that there are no health-related reasons or problems which preclude or restrict Participant's participation in the Program. The Participant is aware of all applicable personal medical needs of Participant and will meet any and all needs for payment of hospital costs while Participant is undertaking this Program and that the Participant hereby grants the University and its agents full authority to take whatever actions they may consider to be warranted under the circumstances regarding Participant’s (or Participant’s baby if born during the Program) health and safety if the Participant is unconscious or otherwise unable to do so her/himself, and fully releases the University and its Agents for any liability for such decisions or actions or expenses as may be taken in connection therewith. The Participant authorizes the University and its Agents, at their discretion, to place Participant at the Participant’s expense, and without

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further consent by Participant or the Participant, in a hospital for medical services and treatment. The Participant hereby releases the University and its Agents from all medical and transportation expenses incurred on behalf of or for the benefit of Participant. 6. The Participant agrees to participate fully in the schedule of the Program. Participant hereby recognizes that the Program and attendant activities are group endeavors and agrees to accept and abide by the University and its agents, or the will of the majority whenever a matter of choice is presented to the group. Participant acknowledges that the University reserves the right to cancel, without penalty, the offering and conduct of the Program and the right to make any alterations, deletions or modifications in the schedule or academic program as deemed necessary by the University or its representative. Participant is not permitted to separate from the group. If Participant breaks the schedule and leaves group, he/she does so at his/her own risk and University will bear no responsibility to Participant. 7. The Participant agrees to respect and abide by the laws of the location(s) of the Program and any other location traveled. Participant agrees to review in advance of the Program, respect and abide by University’s Student Code of Conduct which is incorporated herein and can be found at https://www.ohio.edu/student-affairs/sites/ohio.edu.student-affairs/files/sites/student-affairs/community-standards/Student-Code-of-Conduct-082417.pdf in addition to any other rules provided to the participants at the Program, written or oral. The Participant further agrees to accept corrective actions up to and including termination of participation in the Program if Participant’s conduct is determined to be detrimental the best interest of the Participant, other participants, the Program or University. Participant acknowledges and agrees that he/she may be required to leave the Program at the sole discretion of the University. The Participant also may be required to leave the Program for medical reasons. If asked to leave for any reason, the Participant agrees to immediately leave campus or if Participant is a minor, the undersigned will take immediate action to travel to the University and to take Participant from campus or will make arrangements for the Participant to immediately and safely leave campus. 8. The Participant further agrees that this Agreement shall be construed in accordance with the laws of the State of Ohio, which shall be the forum for any lawsuits filed under or incident to this Agreement or the Program. The term and provisions of this Agreement shall be severable, such that if a court of competent jurisdiction holds any term to be illegal, unenforceable, or in conflict with any law governing this Agreement the validity of the remaining portions shall not be affected thereby.

THIS IS A RELEASE OF LEGAL RIGHTS. READ BEFORE SIGNING. IF PARTICIPANT IS A MINOR UNDER THE AGE OF 18 YEARS OLD, A PARENT OR LEGAL GUARDIAN MUST SIGN BELOW.

I have read the above terms of this Agreement and Release of Liability, and I understand and voluntarily agree to the terms and conditions. This Agreement and Release of Liability shall be binding upon the heirs, administrators, executors, and assigns of the Participant. _________________________________________ Participant Signature Date

As a parent/guardian on behalf of the above-named minor, I have read the above Agreement and Release of Liability Form and I understand and agree to the terms and conditions stated herein. I further indemnify the state of Ohio, Ohio University, its trustees, employees, and agents for any action brought against the state of Ohio, Ohio University, its Board of Trustees, employees, agents, and volunteers by the above-named Participant, including but not limited to an action brought by him or her upon reaching the age of majority. I warrant that I am authorized to execute this document on behalf of the above-named minor.

_________________________________________ _______________________________ Parent/Guardian Signature Date Minor’s Date of Birth For Office Use Only: Date of Activity _______________ + 3 Years = Date of Destruction _______________ Date Child Turns 18 _______________ + 3 Years = Date of Destruction _______________ (For Minors)

Assumption of Risk and Waiver

I acknowledge that there are certain dangers and risks to participating in Ohio Sports Camps, including serious injury and death. I hereby assume all of the risks of participating in Ohio Sports Camps. I certify that I am physically fit, have sufficiently trained for participation in the sport of and that there are no limits to my participation in the sport of except as stated in writing and included with this form. I agree that I will waive, release and discharge Ohio University, its trustees, directors, employees, students, volunteers, representatives and agents from any and all liability for my death, injury or harm of any kind which may occur to me in relation to my participation in the Ohio Sports Camps. I further agree that to indemnify and hold harmless Ohio University, its trustees, directors, employees, students, volunteers, representatives and agents from liability for the injury or death of any persons(s) and damage to property that may result from my negligent or intentional act or omission while participating in the Ohio Sports Camps. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this event.

Participant’s Signature Printed Name Date

Parent’s Signature (if Participant under 18) Printed Name Date