Register · 2026 Summer Camp — Life University Women's Rugby

1 · Participant Details

The camper attending. Please use the participant's full legal name.

Legal first name *

Legal last name *

Preferred name

Date of birth *

Gender

Participant mobile

Participant email

School (2026–27)

Grade / year (2026–27)

Years playing rugby

Experience level

Usual position(s)

Current club / team

Playing kit / jersey size

Camp t-shirt size

Home address *

City *

State / region *

ZIP / postal code *

Country

2 · Parent / Guardian & Emergency Contacts

Primary parent/guardian is the legal signer for this registration.

Primary parent/guardian full name *

Relationship to participant *

Mobile phone *

Email *

Address (if different from participant)

Employer (optional)

Second parent/guardian name

Second guardian phone

Second guardian email

Emergency contact (if not the above) *

Emergency contact relationship *

Emergency contact phone *

Alternate phone

Authorized to collect the participant (names)

3 · Medical & Health

So our athletic trainer and medical team can keep your child safe. All information is confidential.

Family physician name

Physician phone

Health insurance provider *

Policy / member number *

Allergies (food, medication, environmental) *

Current medications (name · dose · schedule)

Medical conditions (asthma, diabetes, epilepsy, concussion history, etc.)

Recent injuries or surgeries (last 12 months)

Dietary requirements / restrictions

May self-carry/administer her own medication?

Tetanus vaccination up to date?

Special needs / accommodations we should know about

4 · Residency & Logistics

This is a residential camp — participants stay in The Commons at Life University.

Roommate request

T-shirt size confirmed above?

Arrival — drop-off date & time

Departure — pick-up date & time

Travel method

How did you hear about the camp?

5 · Consents & Waivers

Please read each agreement and tick to confirm. The full waiver packet PDF is linked in each box.

A. Assumption of Risk, Liability Waiver & Release

Rugby and physical training carry inherent risks of injury. I acknowledge these risks and, on behalf of myself and the participant, release and hold harmless Life University, Life University Women's Rugby, its staff, coaches, volunteers and counselors from claims arising from the participant's involvement in the camp, except in cases of gross negligence or willful misconduct.

📄 Read the full waiver packet (PDF)

I have read and agree to the Assumption of Risk & Liability Waiver. *

B. Medical Treatment Authorization

In the event of injury or illness and if I cannot be reached immediately, I authorize the camp's athletic trainer, medical staff, and/or emergency medical providers to administer first aid and obtain emergency medical treatment for the participant, including transport to a medical facility. I accept financial responsibility for treatment not covered by insurance.

I authorize emergency medical treatment as described. *

C. Code of Conduct

The participant agrees to follow camp rules, respect staff, counselors, teammates and facilities, and understands that serious or repeated breaches may result in dismissal from camp without refund and at the family's transport expense.

We agree to the Participant Code of Conduct. *

D. Photo & Media Release

I grant Life University Women's Rugby permission to use photographs and video of the participant taken during the camp for promotional, educational and program materials, without compensation. Tick "No" below if you do not consent.

I consent to the Photo & Media Release.

No — please do not use images of my child.

E. Residential / Housing Agreement

I understand the participant will be supervised in residence at The Commons, agree to the residential rules (curfew, no unauthorized departure, room care), and accept responsibility for any willful damage caused by the participant.

We agree to the Residential / Housing Agreement. *

F. Camp Fee Acknowledgement

I understand a camp fee applies and that my place is confirmed once payment is completed via the invoice/payment link the camp office will send after this form is received. Registration alone does not guarantee a place until payment is made.

I understand the camp fee & payment process. *

6 · Parent / Guardian Electronic Signature

By signing below, you confirm you are the parent or legal guardian of the participant, that all information is accurate, and that you agree to all the agreements ticked above on behalf of yourself and the participant (a minor).

Signer full legal name *

Relationship to participant *

Date *

Draw your signature *

✕

Use your mouse or finger to sign in the box.

I certify that I am the parent/legal guardian, that the information given is true and complete, and that this electronic signature is legally binding. *

Camp Registration.

1 · Participant Details

2 · Parent / Guardian & Emergency Contacts

3 · Medical & Health

4 · Residency & Logistics

5 · Consents & Waivers

A. Assumption of Risk, Liability Waiver & Release

B. Medical Treatment Authorization

C. Code of Conduct

D. Photo & Media Release

E. Residential / Housing Agreement

F. Camp Fee Acknowledgement

6 · Parent / Guardian Electronic Signature

Registration received