Esports Middle School Camp 2026

Camp Participant Health Information *

A camp participant who is sick before arrival at camp should be kept home for his/her own sake and for that of other camp participants and program staff. There is not medical personnel present at the camp program and camp participants should not be sent to camp with medication, whether prescribed or over-the-counter medication.

In the case of non-emergency injuries and illnesses (i.e., routine scrapes, cuts, upset stomach, etc.) basic first aid protocols will be administered by camp program staff or college campus safety staff. If the camp participant’s condition improves, a parent/guardian will most likely not be contacted during the camp. However, if the condition does not improve or worsens, a parent/guardian will be notified. If a parent/guardian cannot be reached, camp program staff will contact the emergency contact.

In the case of serious injuries or illnesses, camp program staff will contact a parent/guardian immediately. In the event the parent/guardian cannot be reached, this waiver authorizes camp program staff or college campus safety staff to secure prompt treatment at the nearby medical facility.

I hereby authorize WCTC camp program staff to share this information with other WCTC staff members on a need to know basis. I hereby give permission to the camp staff to provide basic first aid or to seek emergency medical treatment. In the event of an emergency, I give permission to the camp staff to arrange necessary related transportation for my camp participant. In the event that I cannot be reached in an emergency, I hereby give permission to the practitioner selected by the camp staff to secure and administer treatment for my camp participant.

This authorization is valid for the summer of 2026. I understand that I may revoke this authorization at any time by submitting written notice of the withdrawal of my consent. I also understand that this information is released to aid in the treatment and care of the camp participant.

Physician Name *

Physician Phone Number *

WCTC Standard Model Release - Please Check Only One Box Below *

I hereby authorize and give full consent to Waukesha County Technical College to copyright or publish all photographs or video productions taken in which the participant appears during the Program Camp. I further agree that Waukesha County Technical College may use, and/or cause to be used, these photographs or video recordings for any and all exhibitions, public displays, publications, commercial art or advertising purposes, and the college website, without limitation or reservation or any compensation other than that receipt of which I hereby acknowledged.

I hereby decline and do not authorize Waukesha County Technical College or its representatives to use, copyright or publish all photographs or video productions taken in which the participant appears during the Program Camp.

ACKNOWLEDGMENT OF RISKS / ACCEPTANCE OF RESPONSIBILITY AGREEMENT AND RELEASE *

Acceptable conduct by Participant
* Participant is aware of the behavior expected while participating in the Program. There is certain behavior that is unacceptable and could lead to possible disruption or discontinuation of Participant’s involvement in the Program, including; but not limited to loud, boisterous, offensive, or otherwise inappropriate conduct, the improper use of alcohol or other drugs affecting participant’s involvement in the Program as well as, carrying any firearms or other weapons while participating in the Program. Participant agrees to exercise reasonable care at all times with respect to Participant’s own safety and with respect to the safety of others. Participant agrees to abide by all rules, policies and procedures of WCTC that are set forth in the Code of Conduct found on the WCTC’s website: https://www.wctc.edu/campus-life/safety-policies/student-code-of-conduct/index.php as well as any additional rules, policies and procedures of the location of the Activity. Participant has no health-related issues that would preclude or restrict participation in the activity.

Waiver of WCTC's Liability and Indemnification of WCTC for Risks and Dangers
* As a condition precedent to Participant’s involvement in the Program, Participant agrees to exercise reasonable care at all times with respect to the safety of Participant’s own person and personal property, and with respect to the safety of other Participants and their personal property. Participant understands, however, that there are certain dangers, hazards, and risks inherent in the activities included in the Program. Participant acknowledges that involvement in the Program may involve the risk of damage to property, bodily injury, and, in some cases, even death. Neither WCTC, nor the Program’s Coordinator, assumes any responsibility for such personal injuries or property damage. Participant further acknowledges that he/she is at least eighteen (18) years of age and is competent to submit this document. If Participant is a minor under the age of eighteen (18) years of age, the parent and/or guardian acknowledges they are competent to submit this document on behalf of the Participant.

Participant also understand that there are certain dangers, hazards, and risks associated with traveling in a motor vehicle, traveling on public highways and/or private property, entering and traveling through a business or facility, including those businesses or facilities utilizing heavy machinery/equipment and/or hazardous materials, slips, trips, falls, and any other risk or hazard which might present itself.

Accordingly, Participant, for him/herself and the Participant’s spouse (if applicable), heirs, assigns, related individuals and related entities, does hereby waive, release, absolve, discharge and agree to hold harmless WCTC and their Boards of Trustees, directors, officers, employees, teachers, agents and insurers, and the Program’s Coordinator (collectively, the “Released Parties”), from and against any and all rights, claims, demands, causes of action, obligations, suits, liens, damages, or liabilities of any kind and character whatsoever, whether known or unknown, suspected or claimed, which the Participant shall, or may have, in the future against the Released Parties arising out of, based on, related to, or connected with, the Participant’s enrollment and participation in the Program. Participant also agrees to indemnify and hold the Released Parties harmless from the payment of any and all judgments, settlements, costs, disbursements and attorneys’ fees that are associated with the Released Parties having to defend or investigate any claim, action or proceeding of any type whatsoever arising out of the Participant’s enrollment or participation in the Program, including, but not limited to, claims for breach of contract, negligence, strict liability, or otherwise. This indemnification obligation and Agreement and Release does not, however, absolve the Released Parties from any liabilities, damages, costs, disbursements, and attorneys’ fees incurred due to its intentional or reckless conduct.

Participant understands that if any fact with respect to which this Agreement and Release is executed is found hereafter to be other than or different from any fact now believed by Participant to be true, Participant expressly accepts and assumes the risk of such a possible difference and agrees that this Agreement and Release shall be and remains effective not withstanding such difference in facts.

Governing Law: Forum
* Participant agrees that this Agreement and Release shall be construed in accordance with the laws of the State of Wisconsin, which shall be the forum for any lawsuits filed under, or incident to, this Agreement and Release. The terms and provisions of this Agreement and Release shall be severable, such that if a court of competent jurisdiction holds any term to be illegal, unenforceable, or in conflict with any law governing this Agreement and Release, the validity of the remaining portions shall not be affected.

Other Provisions
* The Released Parties are granted permission to authorize emergency medical treatment, if necessary, and that such action by the Released Parties will cause them to assume no responsibility for any injury, damage or medical expense which might arise out of, or in connection with, such emergency medical treatment. It is the Participant’s express intent that this Agreement and Release shall bind the members of the Participant’s family and spouse (if applicable); and if the Participant is deceased, it shall be deemed as a release, waiver, discharge, and covenant not to sue the Released Parties by the Participant’s family and spouse (if applicable), for any matter arising out of Participant’s involvement in the Program.

This Agreement and Release requires you to give up substantial legal rights. By submitting the registration form, Participant acknowledges and represents that he/she is fully informed of the contents of this Agreement and Release. By reading it before submitting it, and by submitting it as the Participant’s own free act, Participant confirms that no oral representations, statements, or inducements, apart from those made herein, have been made.

Camp Payment

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