Official Keystone Mascots Camp Registration Form

Who?

Three day training camps for high school, collegiate, corporate, professional sports, and individual mascots.

What?

Learn the basics of character development, performance skills, costume care, and working with advisors and other spirit groups.  Each camper will take home skits they can use at games or special promotional events, video recordings of themselves in action and in practice, and our official Keystone Mascots Training and Administrative Manual.

Where and When?          August 4-6, 2023         Location: Lancaster, Pa.        Host: Millersville University

9:00 am to 4:00 pm each day at the Student Memorial Center, Monday 9:00 am to 1:00 pm. 

Keystone Mascots Training Staff who have experience in MLB, NHL, NFL, NCAA, Disney World, Hersheypark, and other corporate and professional sports venues.

 

Name: __________________________________________ 

 

Camper/Parent/Guardian Email Address_______________________________________________

 

Organization: ___________________________________ Phone: _________________________

 

Mailing Address: _________________________________________________________________

 

City: ____________________________________ State: ______ Zip: ______________________

 

Mascot Advisor: _________________________________ Phone: _________________________

 

Advisor’s Email Address: __________________________________________________________

 

If you paid through PayPal ____  Check or Money Order: _____

If mailing send Check/Money Orders to:

Keystone Mascots LLC, Box 553, Brownstown, Pa. 17508  (717) 799-0233

 

If you are above the age of 18 and plan to participate during any Keystone Mascots Summer Camp you must have volunteer child abuse clearance form copies delivered to Keystone Mascots and Millersville University no later than JULY 15.  The volunteer clearances are free.  You can find information at this link:

http://www.psp.pa.gov/Documents/Public%20Documents/fingerprint_info/Fact%20Sheet%20for%20Volunteers%20Final%20.pdf

Pa. state records are free-of-charge for volunteers.  Please phone these offices before filling out your application.

KEYSTONE MASCOTS LLC RELEASE AND WAIVER OF LIABILITY ASSUMPTION OF FULL RESPONSIBILITY FOR ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE AND INDEMNITY AGREEMENT

The participant and parent(s) or legal guardian(s) will instruct the minor participant that prior to participating in any and all activities or use of any and all equipment or facilities, they should inspect the facilities and equipment to be used with me, and if they or I believe that anything is unsafe, the participant or I will immediately advise a Keystone Mascots LLC., staff member of the condition, and refuse to participate.

I, as the minor participant and my parent, prior to participating in any and all activities, have inspected the equipment and facilities to be used, and believe them to be safe, and am satisfied with the condition of the facilities and equipment.

We fully understand and voluntarily accept that:

a.       There are risks and dangers associated with participation in any and all activities, which could result in, but are not limited to, bodily injury, partial and/or total disability and death.

b.       I, as the minor participant, have no physical or mental condition which would interfere with my ability to participate in or attend any such event or activity, or which would endanger my health or safety.

c.       I am warranting that my minor child/ward has no mental or physical condition that would interfere with their ability to participate in or attend any such event or activity, or that would endanger his/her health or safety.

d.       The social and economic losses and/or damages, which could result from those risks and dangers described above from said participation in any and all activities, could be severe.

e.       These risks and dangers may be caused by the actions, inaction, negligence or carelessness on the part of Keystone Mascots LLC., or any of its officers, agents, servants, or employees.

f.        There may be other dangers and risks from said participation in any and all activities not known to us or not foreseeable at this time.

IN CONSIDERATION of permitting _________________________ to participate in any and all

activity with Keystone Mascots LLC, beginning on the ____ day of ____________, 202___, the undersigned agrees for themselves, their family, their heirs, administrators and assigns, and voluntarily releases, discharges and promises not to sue and not to hold liable Keystone Mascots LLC. or any of its officers, agents, servants or employees for any and all claims for personal injury, property damages or wrongful death occurring to himself/herself arising out of engaging (or receiving instructions) in said activity or any activities incidental thereto whenever or however it may occur and for whatever period the activities or instructions may continue and whether it is caused by the negligence or carelessness, or otherwise, of the persons or entities conducting or sponsoring the event or instruction.

The undersigned further agrees, for themselves, their family, their heirs, executors, administrators, and assigns, that in the event any claims for personal injury, property damage or wrongful death shall be prosecuted against Keystone Mascot LLC. or any of its officers, agents, servants or employees, they shall indemnify, save and hold harmless the same Keystone Mascots LLC. or any of its officers, agents, servants, or employees for any and all claims by whomever or wherever made for personal injuries, property damage or wrongful death whether caused by the negligence, carelessness, or otherwise, of the persons or entities mentioned above.

On behalf of the minor participant and individually, the Undersigned parent(s), or legal guardian(s) for the minor participant executes this Release and Waiver. If, despite this release, the participant makes a claim against the Keystone Mascots LLC. or any of its officers, agents, servants, or employees the parent(s) or legal guardian(s) agree that he/she/they:

1.   Will reimburse/indemnify Keystone Mascots LLC. or their insurance company for any money, which they paid to the participant

2.   Will reimburse/indemnify Keystone Mascots LLC. or their insurance company for any reasonable costs incurred, including attorney’s fees.

3.   Will hold Keystone Mascots LLC. harmless.

I, on behalf of the minor participant and individually, further agree and promise to hold harmless and indemnify Keystone Mascots LLC.. or any of its officers, agents, servants, or employees from all deferred costs, including attorney’s fees, or from any other costs incurred in connection with claims for personal injury, property damage or wrongful death which I, or the minor participant, may negligently or intentionally cause to a third parties in the course of participating in any and all activities.

If any portion of this agreement is held invalid, it is agreed that the balance thereof shall continue in full leg force and effect.

It is the intention of _________________________ by this document to relieve Keystone Mascots LLC. or any of its officers, agents, servants, or employees from any responsibility for personal injury, property damage or wrongful death whether caused by the negligence, carelessness, or otherwise, of the persons or entities mentioned above.

We take pictures of our camps throughout the year for our website. Please note that your child/ward may be photographed and may appear on our website. By signing this waiver you are giving consent for such an occurrence.

I UNDERSTAND I AM ASSUMING ALL RISKS INHERENT WITH ANY AND ALL ACTIVITIES THAT I AM PARTICIPATING IN, WHETHER KNOWN OR UNKNOWN, AND THAT BY SIGNING THIS DOCUMENT I AM GIVING UP MY RIGHT TO SUE KEYSTONE MASCOTS LLC. WHETHER CAUSED BY THE NEGLIGENCE OF THE SAID PERSONS OR ENTITES.

I VOULUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THE ABOVE PROVISIONS, AND FURTHER AGREE THAT NO ORAL REPRESNETATION, STATEMENTS OR INDUCEMENTS APART FROM THE AGREEMENT HAVE BEEN MADE.

I HAVE READ THE DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS.

1. ______________________________________ ________________________________

             Parent or Guardian (Signature/Relationship)            Date

2. _______________________________________

            Child (Signature if old enough)   Date

3. _______________________________________

            Witness (Signature)        Date

 

MEDICAL INFORMATION CARD

 

 

Participant’s Name: _____________________________   Explain any “YES” answers              Date: _________________

Have you had any illness or injury since your last physical?

Have you had any surgery?

Are you currently taking any prescription or non-prescription medications?

Do you have any allergies? (Food, Medications, Insect Stings, etc.)

Do you have asthma?

Do you have heart disease?

Do you have headaches?

Do you have seasonal allergies?

Do you wear glasses or contacts?

Do you have Diabetes?

Have you had previous fractured bones or dislocated joints?

Record the dates of your most recent immunizations

Tetanus____________ Hepatitis B____________ Measles____________ Chicken Pox____________

Signature Required I, ___________________________________the parent/guardian of __________________________,

give permission for emergency medical treatment of my child if I cannot first be contacted.

___________________________________________________________________________________.

Signature Required – Participant or Parent / Guardian

Please list and describe any other medical concern(s) that we should be aware of:

______________________________________________________________________________________

Warning of Risk to Participant & Insurance

Keystone Mascots LLC. is not responsible for providing medical accident injury insurance on students. Parents must provide adequate accident and medical insurance for the student enrolled in training with  Keystone Mascots.  Keystone Mascots LLC. shall not be held responsible for treatment or losses due to participation in activities before, during or after classes or due to activity connected to the complex hosting camp.

Please be advised that any activity involving motion or height creates the possibility of accidental injury. Parents and participants should be aware that injury is possible in connection with this or any athletic activity.

Parents assume all responsibility for any injury and all medical costs due to participation in any activity at Keystone Mascots training camp and the host venue.

I have read the above policy and both understand and accept it.

 

___________________________________      ___________________                   

               Signature                                                  Date

CAMP CURRICULUM INFORMATION FORM

I would like to learn: (circle three items):

Dancing                        Acting                           Skits                              Liability/Safety

Working with Cheerleaders, Band                    Props                  Tumbling/Gymnastics

Stiltwalking                   Clowning             Improvisational Comedy        Costume Care

Community Event Campaigns                 Fundraising/Money Generation

How to use a Flag/Signs                Working in Professional Sports      Sportsmanship

Working for an Amusement Park            Health and Nutrition              Character Building

Setting Realistic Goals          Working with Groups of Fans         College Scholarships

Other: