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Summer - Middle School

Athlete Personal Information
Parent/Guardian Information
Session Preference
Confidential Demographic Information
Photo Release and Liability Waiver
I give PCR permission to use my child’s photo in materials that promote PCR. This may include brochures, newsletters, the Internet or other electronic media, magazines or television.
I agree to the above

In consideration of PCR permitting my child to participate in PCR’s activities and programs, I, on behalf of myself and my child, hereby release, discharge and agree to indemnify and hold harmless the City of Philadelphia (the “City”), PCR and both the City’s and PCR’s officers, directors, employees, subcontractors, volunteers and agents from any and all claims, liabilities or causes of action arising out of (1) the student’s participation in PCR’s activities and programs, or (2) the student’s use of PCR’s rowing facility, equipment, or other premises where practices and competitions take place.
I hereby give my child permission to participate in any and all programs associated with PCR, including, but not limited to, PCR’s rowing and educational programs and field trips related thereto. I understand that PCR activities may include one or more of the following: rowing on the Schuylkill River; indoor training at venues to be specified; competing in regattas in and out of Pennsylvania; swim test and swim lessons; and other such activities, including tutoring and mentoring, as they relate to the goals of PCR. It is anticipated that PCR will regularly utilize vans and/or cars to transport participants to practices, races, field trips and other events. I hereby give my permission for my child to be transported either (i) with the entire team to these events in the vans and/or cars used by PCR for transportation to these events or (ii) in the event that vans and/or cars do not have the capacity to transport all the rowers, coaches and other PCR officials and volunteers, in a bus or with one of PCR’s employees, coaches, officials or other volunteers in a private automobile.
I further give my permission to PCR to give consent on my behalf in the event of the need for the emergency administration of medical treatment which PCR, in its sole discretion, believes to be necessary and appropriate, including, without limitation, treatment by trained First Aid personnel, EMTs, First Responders, Paramedics and Emergency Room Physicians. In consideration of PCR permitting my child to participate in PCR’S activities and programs, I, on behalf of myself and my child, hereby release, discharge and agree to indemnify and hold harmless the City, PCR and both the City’s and PCR’s officers, directors, employees, subcontractors, volunteers and agents from any and all claims, liabilities or causes of action arising out of such treatment and with respect to the exercise of its and their judgment in this regard. I further attest that I have disclosed all vital and important health information (allergies, medications and medical limitations on activities) which would be necessary for the proper care of my child. I agree to pay and to assume responsibility, for all medical expenses incurred in the treatment of my child.

 

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