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Participant Details
Other Medical Concerns?
What level of sports (your choice) experience do you have ?
Social Media Release

I, the undersigned, do hereby grant permission to Empower me Training to

post my and/or my child’s story, photo, or other item, hereinafter referred

to as “Materials,” I submit to add for Empower Me Training’s Web site,

Twitter account, and Facebook account.


I hereby to release you, your representative, employees. managers, members, officers, parent companies, subsidiaries, and directors, from all claims and demands arising out of or in connection with any use of said “Materials”, including, without limitation, all claims for invasion of privacy, infringement of my right of publicity, defamation and any other personal and/or property rights.

I acknowledge and agree that no sums whatsoever will be due to me as a result of the use and/or exploitation of the “Materials” or any right therein.


I acknowledge that my child is under 18 years old and lacks that legal capacity to enter into binding agreements. Accordingly, I have read this Release and consent to my child’s inclusion in the Materials will not contest the rights granted in this Release, and shall assist and support you in any and all legal proceeding for affirmation of this Agreement, should you choose to have a court of law affirm this Agreement. 

Photo Recording Release

I grant permission to EMPOWER ME TRAINING to use, reproduce and communicate (in hardcopy or electronic format) any photographs, audio and/or video recordings taken of me on the date below, for the following purpose:

  • EMPOWER ME TRAINING publications and promotional activities (including but not limited to EMPOWER ME TRAINING’s website and social media sites, promotional and marketing materials and student/client recruitment activities)

  • EMPOWER ME TRAINING’s administrative and training purpose.

I acknowledge and agree that this may result in public disclosure of my image.

Risk Warning & Waiver 

Participant in the School Holiday Camp involves the risk of personal injury. Particular risks include, but are not limited to torn muscles, scrapes, bruises.

Before you participate in the School Holiday Camp activity, you should ensure that you are aware if, and properly understand, all of the risks involved in the School Holiday Camp, and that those risks will include any particular risks associated with any health condition or pre-existing disability from which you suffer.

By agreeing this agreement, I acknowledge, agree and understand that I engage or participate in the School Holiday Camp voluntarily and at my own risk in full knowledge of the risks generally and particular risk described above.

If signing this agreement as a parent, guardian or responsible person performing parenting responsibilities, you acknowledge, agree and understand that you explained to the participant that the School Holiday Camp may involve risks generally; ad the Particular risks described above.

Thanks for submitting!

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