top of page

Rich Elite Summer Camp

June 3, 2024 - June 7, 2024 (Orientation Week)

June 10, 2024 - July 17, 2024 (Summer Camp)

Registration Form

Birthday
Gender
Grade for 2024/2025 School Year
T-Shirt Size
Youth (S)
Youth (M)
Youth (L)
Youth (XL)
Adult (S)
Adult (M)
Adult (L)
Adult (XL)
Other

APPROVED PICK-UP

CONTACT INFORMATION # 1

CONTACT INFORMATION # 2

CONTACT INFORMATION # 3

Waiver and Release of Liability

and

Photo Consent

In consideration for Participant's participation and registration in any program, camp, or event designed or created by The B.Rich Project, Inc., if participant is a minor (17 years and younger) ("releasor(s)"), as the responsible parent(s)/guardian(s) of above listed participant (minor) hereby release, waive, discharge and covenant not to sue The B. Rich Project, Inc., its employees, volunteers, program partners, activity leaders, sponsors, guest speakers, (Bros. Elite) sanctioning organizations, Polk County Public Schools or any subdivisions thereof, field operators, sports officials, owners and lessees of premises used to conduct programs, events and/or practices ("releasees") from all liability and from any and all loss or damage, and any claim or demands therefore, on account of injury to the named Participant above, whether caused by the negligence of the releasees or otherwise while the named Participant is, for any purpose, participating in any activities designed or facilitated by The B.Rich Project, Inc and any of is associated entities.


Releasor(s) hereby assume full responsibility for the risk of bodily injury to the named Participant due to the negligence of releasees or otherwise while the named Participant is, for any purpose, participating in any event. Further, releasor(s) expressly acknowledge that Participant's participation in program is inherently dangerous and involves the risk of serious injury, or death, and agree that the foregoing release is intended to be as broad and inclusive as is permitted by the law of the State of Florida.


Releasor(s) realize(s) that The B.Rich Project Inc. its employees, volunteers, activity leaders, sponsors, guest speakers, and Polk County Public Schools carry no medical insurance covering participation in these activities.


This release constitutes a release or waiver of all claims against The B.Rich Project, Inc including those claims arising out of negligence of The B.Rich Project, Inc, its employees, volunteers, program partners, activity leaders, sponsors, guest speakers, Bros. Elite, and Polk County Public Schools. This release is signed of my/our free act and will.

Photo & Video Consent: As the responsible parent/guardian of the participating minor, I hereby consent to the use of any photos and video footage taken by The B. Rich Project, Inc its partners its employees, volunteers, program partners, activity leaders, sponsors and guest speakers of myself or my children during participation in this program, or event, for which the above Release and Waiver has been executed. I agree such photos and video footage shall be the sole property of The B.Rich Project, Inc. and neither myself or the individual(s) on whose behalf this consent is signed are entitled to compensation of any kind for use of such photos or video footage taken by The B.Rich Project, Inc. its employees, volunteers, and program partners.

Date

Please upload a copy of the following:

  • Driver's License of authorizing parent/guardian

  • Participant's final report card (2023 - 2024 school year)

Registration Costs (Half Day)
Registration Costs (Full Day)
  • Facebook
  • Twitter
  • YouTube
  • Instagram
bottom of page