(785) 871-7245

FREE DEAF & HARD OF HEARING SUMMER CAMP

AUGUST 10- 14, 2026
9:00 AM - 12:00 PM

Camper's Full Name
Selected Value: 0
Interpreter Required
best contact number
Parent/Guardian Name

Two Emergency contacts ( name, phone and relationship )

RELEASE AND WAIVER OF LIABILITY
The undersigned hereby acknowledges that I am fully aware that participation in athletic
programs and recreational activities involves an inherent risk of physical injury and on
behalf of myself and my child assumes and accepts all risks attendant to my child’s
participation in activities, events and excursions related to the Sertoma Fantasy Baseball
Camp (the “Camp”). The undersigned hereby agrees that for the sole consideration of my
child’s participation at the Camp and Dickinson College (the “Hosting institution”)
allowing the undersigned’s child to participate in voluntary recreational programs or
athletic activities and, in connection therewith, making available to the undersigned for
their use while participating in such programs or activities, certain equipment, facilities,
grounds, or personnel, the undersigned on my behalf and on behalf of my child and each
and every of my and my childs heirs, executors, administrators, successors,
representatives, and assigns, does hereby waive liability, forever release and discharge
the Camp, the Hosting institution, their board members, trustees, officers, agents, insurers
and employees of and from any and all claims, demands, rights and causes of action of
whatever kind or nature, arising out of all known and unknown, foreseen and unforeseen
bodily and personal injuries, damage to property, and the consequences thereof, including
death, resulting from my voluntary participation in or in any way connected with such
recreational programs and athletic activities.
I covenant and agree that for the consideration stated above, I will not sue the camp, the
hosting institution, or their board members, trustees, officers, agents or employees for any
claim for damages arising or growing out of my voluntary participation in recreational
programs or athletic activities.
I further acknowledge that if I am making payment for this camp and the payment is
made payable to any entity besides the Hosting institution, the Hosting institution is not
and shall not be deemed as an owner, co-owner, or otherwise affiliated with the Camp,
and is only allowing the Camp the ability to utilize its property for the purposes of
hosting the Camp. As such, I agree to hold harmless and indemnify the Hosting
institution, its board members, trustees, officers, agents and employees from any all
liability, actions, causes of action, negligence, debts, claims, or demands of any kind and
nature whatsoever (including attorney fees and costs) made by any person or entity on my
behalf which may arise by or in connection with participation in this program.
I have received a copy of this document and read it carefully, and I certify that I am 18
years of age or older and suffering from no legal disabilities that would impair my ability
to comprehend and lawfully sign this agreement.
Minor Child Photo Release Form
I the parent or legal guardian said child grant Primal Sports Charities, Sertoma and Dickinson College my permission to use the photographs described as sports footage such as but no limited to game, practice, camp, headshots, and team photographs for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content.

Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
I agree to the following charge:

ANNUAL FREE YOUTH BASEBALL CAMP

The Carlisle Sertoma Club and Primal
Sports are proud to host our annual,
free, 5-day baseball camp for all Deaf
and hard-of-hearing boys and girls
ages 5-15.

Empowering student-athletes and veterans through education, outreach, mentorship, and scholarship opportunities. A 501(c)(3) nonprofit based in Carlisle, Pennsylvania.

© 2025 Primal Sports Charities, Inc. All rights reserved. 501(c)(3) Nonprofit.