TO PARENT:

This is a CALL (Character, Academic, Love, Leadership) financial literacy development Outreach Camp. Throughout the day Destined To Succeed Mobile Mission, Inc. Basketball Camp uses Christ like principle techniques to encourage the youth to pursue their dreams and aspirations through the Love of YESHUA CHRIST JESUS!

Would you like your child to participate?   [  ] YES          [  ] NO

Parent’s/Guardian Signature___________________________________________________________

Medical Release Form:I do recognize there are inherent risks involved in this sport activity. In consideration of the services provided, I hereby release and hold harmless the Destined To Succeed Mobile Mission, Inc to call for, administer and/or obtain medical attention for my child in an emergency.  I also hereby release personnel and agents of the Destined To Succeed Mobile Mission, Inc., from any liability and/or damages as a result of participation in the camps. Furthermore in the event of an emergency requiring medical attention, I shall pay for the services rendered.Parent Signature:_______________________________________DATE_________________Emergency Contact Name(s):_____________________________________________________________Phone(H):___________________________________(W)______________________RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITYAND PARENTAL CONSENT AGREEMENT ("AGREEMENT")In Consideration of being permitted to participate in any way in the ANY FIELD OR GYM ("Activity") I, for myself for personal representatives, assigns, heirs, and next of kin:1. ACKNOWLEDGE, agree, and represent that I understand the nature of ALL Activities and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.2. FULLY UNDERSTAND THAT: (a) ANY FIELD ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by my own actions or inaction’s, the actions or inaction’s of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISK AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time;and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity.3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE Destined To Succeed Mobile Mission, Inc. their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owner of premises on which the Activity takes place, (each considered one of the "RELEASES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY,ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim VALERIE against any of the Releases, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim. I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAWAND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.EVENT:_______________________________________________________Parent of Guardian Signature(if minor)______________________________Parent of Guardian Signature(if minor)______________________________Participant’s Signature (only if age 18 or over):________________________Printed Name of Participant_______________________________________Address of Participant________________________________________________________________________________________________________Email Address_________________________________________________Date: ____________Minor Release and Authorization To Reproduce Physical Likeness & Voice:MINOR RELEASE AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THENATURE OF ALL ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVETHE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TOPARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE,AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ALL LIABILITY CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATION AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR’S BEHALFMAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNITY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM. Furthermore, I authorize Destined To Succeed Mobile Mission, Inc., to transport and release minor to a medical facility in the event that Destined To Succeed Mobile Mission, Inc., judgment, emergency medical attention is immediately required and the minor’s parent and/or legal guardian’s are unable to be contacted.Authorization To Reproduce Physical Likeness & Voice:

I,_________________________, hereby grant to Destined To Succeed Mobile Mission, Inc., and to any third party that they may authorize, the right to use my name and the right to photograph, film, tape and record me, and to use such pictures, other reproductions or modifications thereof in the advertising, exploiting or publicizing of Destined To Succeed Mobile Mission, Inc., in any media.[ ] YES [ ] NOSignature:_____________________________________________________Parental Consent for Minor Child: I hereby authorize and consent to the above authorization on behalf of my (Son/Daughter)Parent’s Signature:______________________________________________________Athlete Code of Conduct 



The members and volunteers of Destined To Succeed Mobile Mission, Inc., are happy that you are participating. We look forward to Destined To Succeed Mobile Mission, Inc., as much as you do. We hold the clinic because we know that some of you have not had a chance to participate in sports in your school. You will have a lot of chances here at DTOSMM! We feel that you have a responsibility to try as hard as you can while you are here. We know that all of you will not be superstars, but we do expect you to try as hard as you can. We assume that anyone who is at the DTOSMM is here to concentrate on becoming a better person, student, and athlete. Occasionally, we have had to send athletes home because of poor behavior. So that you know what is expected of you, you must agree to the following statements.
AS A Destined To Succeed Mobile Mission, Inc.,

 ATHLETE, I AGREE TO:Conduct myself as an athlete during the DTOSMM . That means, I will try my best to do as well as I can in each activity.Treat the other athletes fairly and with respect.Abide by the following DTOSMM rules:I will not leave my group without permission.I will not leave the gym or sports activity without permission.I will not fight and use profane language.I will be a good sport whether I win or lose.I will report poor behavior of others to the camp director.Athlete’s Signature___________________________________________________________________________________Parent’s/Guardian Signature_________________________________________________________________________Date________________Staff Signature________________