My child has permission to attend the National Kicking Service kicking camp. I will notify NKS if my child is on medication or is restricted in any way from participating in all activities. In the event of any emergency in which my child requires medical care, I authorize the NKS staff to act for me and obtain whatever medical treatment the staff in its best judgement deems necessary and appropriate. I specifically consent to such treatment including but not limited to hospitalization and surgery and will be responsible for any medical or other charges in connection with attendance at camp.

I acknowledge that at NKS kicking camps my child will participate in a sport that may involve among other things, physical contact with the body with other persons or objects, including the ground, that at the NKS kicking camps my child may incur a risk of injury. I specifically waive and give up and release National Kicking Service, its owners and staff, the owners, trustees and staff of the premises on which the NKS kicking camp is held from liability for any claim for damages which I or my child may have for injuries or illness that may be sustained at the NKS kicking camp.

I authorize NKS to use any photographs or articles about my child for publicity purposes.

Parent/Legal Guardian/Participant (18 yrs or older) Signature