Gentry Academy Shadow Day

Student Shadow Registration



By submitting this form, I hereby agree that I am the legal parent or guardian of this student. I have completed the above medical information and have indicated my preferences for my student's treatment. In consideration for being allowed to participate as a registrant at the Gentry Academy Shadow Days, I acknowledge and agree that: I/We recognize that there are inherent risks of serious injury to my child, including, serious damage, personal injury, paralysis, or death, as a result of his/her participation in the game of hockey, as well as off and on ice training, in-line skating, dry land sporting activities, ice-skating and any and all other activities involved in this camp. I/We hereby consent, having full awareness of all my rights and what this Waiver encompasses and releases, on behalf of myself, and my child, to allow My/Our child to participate in the Gentry Academy program at our own risk. Further, I/We hereby consent to and allow Gentry Academy to use any pictures and/or video taken during the course of the program activities which can be used by Gentry Academy in any manner they see fit, without charge, including but not limited to advertising in and on newsletters, websites, social media pages and/or any other marketing or advertising materials. I/We understand and agree that Gentry Academy and its instructors, directors, employees, agents, officers, subsidiaries, independent contractors, affiliates or any other person hired by it will not be held responsible for accident, injury, loss or damage, however caused, and I/We, on My/Our own behalf and on behalf of My/Our child, do hereby release the above stated parties from all claims, damages, actions, loss and expenses which may arise as a result of accident, injury, loss or damage to my child or myself. I/WE understand and acknowledge that My/Our child and I/We shall comply with all stated terms and policies as implemented and required by Gentry Academy, including but not limited to, sportsmanship, integrity, teamwork, and academics. I/We fully acknowledge and agree that pursuant to the terms of this Waiver and General Release it is My/Our responsibility for the payment of any and all medical costs for injuries or damages arising from or around My/Our child’s participation in activities as provided by Gentry Academy. I/We acknowledge that My/Our child does not suffer from any known medical condition that would and/or should restrict him/her from participating in any and/or all activities offered by Gentry Academy. In the event that I/WE become aware of such medical condition, I/WE will immediately notify Gentry Academy and any and all applicable instructors, teachers, or coaches immediately. In the case of a medical emergency, I/WE give permission to Gentry Academy, its officers, employees, instructors, and agents to seek medical attention for My/Our child, if I/We, the parent or legal guardian, am/are absent. I/We have read and fully understand the waiver and the risks as stated herein, and agree to its terms by signing below. I/We fully acknowledge and understand that this Waiver and General Release shall be binding on Me, My spouse, My children, My legal representatives, My heirs, My successors and My assigns. I affirm that photographs and video may be taken of me and/or the undersigned minor child. I hereby authorize Gentry Academy* to use any such photographs or videos containing my image or likeness and/or the undersigned minor child’s image or likeness, and our names, for promotional or marketing needs, including but not limited to printed material, videos, and websites. *Gentry Academy shall include Gentry Academics, a Minnesota Non-Profit Corporation, and Gentry Academy, Inc. Gentry Academy shall also specifically include any affiliated companies of Gentry Academics and/or Gentry Academy, Inc.