Basketball Camp Registration

I, the undersigned parent/legal guardian, am responsible for arranging and providing transportation for my minor child to and from the camp location(s) unless alternative arrangements are made.

Drop off time will be 8:30 – 9:00 AM
WSU Spokane (SAC Building),
412 E Spokane Falls Blvd, Spokane, WA 99202

Pick up will be at 5:30 – 6:00 PM at
Shaw Middle School
4106 N Cook St, Spokane, WA 99207

1. WSU assumes responsibility for my minor child only upon arrival at the designated program location the event site.

2. WSU retains responsibility until the official program departure time from the event location.

3. Responsibility for my minor child reverts to me upon program departure from the event location.

In an emergency requiring medical attention or a situation reasonably believed to be an emergency by Washington State University (WSU) authorized agents including camp staff, the undersigned parent and/or legal guardian authorizes WSU and its authorized agents to obtain emergency medical care for Participant. In these situations where possible, WSU will first make efforts to contact the parent(s) or legal guardian in advance of obtaining medical care for Participant. Parent and/or legal guardian will be responsible for any expenses incurred in so doing including but not limited to care by health care professionals, hospital care, and ambulatory or other medical services. In addition, the health care provider has permission to obtain a copy of Participant’s health record from the provider(s) who treats Participant, and these/this provider may talk with the camp program’s staff about Participant’s health status.

Parent/legal guardian agrees to be solely responsible for any and all medical and healthcare expenses, fees and costs Participant receives or is sought while a camp participant. Parent/legal guardian agrees to hold harmless and agrees to indemnify Washington State University, its authorized agents and employees and the event staff for decisions to seek emergency treatment for Participant including all costs, fees and expenses associated with the decision to obtain healthcare services and treatment.

Consent is given for the Participant to receive medical treatment, which may be deemed advisable in the event of injury, accident, or illness during this event. In compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), consent is given for medical providers to advise Native American Health Sciences and Native American Health Sciences staff of Participant’s physical, emotional, and/or mental health condition and recommended healthcare treatment plan.

Parents/Guardians, please note that Participants are not to leave our program to attend activities or events that occur within the duration of the camp unless for a family emergency, removal by a parent/guardian, or medical non-emergency. Requests made by Participants or parents to leave camp without camp counselors and staff to meet with family or attend events for any other reason will be denied.

In consideration for the opportunity to participate in WSU's Native American Health Sciences programs, I voluntarily agree to assume all risks involved in my participation or traveling to or from it. I understand that if I voluntarily participate, I expose myself to risk of personal injury and/or death and property damage or loss including, but not limited to the following:

Lab activities, transportation to and from or during field trips, classroom workshops and recreational activities include, but are not limited to: temporary or permanent muscle soreness, sprains, strains, cuts, abrasions, bruises, ligament and/or cartilage damage, orthopedic damage, head, neck or spinal injuries, loss or use of arms and/or legs, eye damage, disfigurement, burns, drowning or death. Further, I recognize that the actions of other participants in the activity may cause harm or loss to the participant or my property.

I also recognize that there are both foreseeable and unforeseeable risks of injury or death that may occur that WSU cannot specifically anticipate and list here.

I release the state of Washington, the Regents of WSU, WSU, any subdivision or unit of WSU, its officers, employees, and agents, from any and all liability, claims, costs, expenses, injuries and/or losses, that I may sustain as a result of my participation in the above event. My participation includes, but is not limited to, travel to and from the event in a private or public vehicle, and any activity connected with the event itself, and while using state equipment or facilities for the event whether on or off WSU property.

I hereby grant permission to Washington State University Spokane and its affiliated colleges of Nursing, Medicine, Pharmacy and Pharmaceutical Sciences, all assigns and licensees, to create photographs or videos of me and to make recordings of my voice. I give WSU permission to use these images, videos, and recordings, as well as my likeness, name, and voice, as follows:

In reproduction, distribution, derivative works, display, and performance.
In composite or modified forms in any media, now known or later developed, including without limitation print collateral, newspapers,
television, radio, the World Wide Web, and social media.
For any purpose throughout the world and in perpetuity, including, without limitation, education, trade, advertising, and promotion.

Student Information: The Family Educational Rights and Privacy Act (FERPA)

The Family Educational Rights and Privacy Act and the Washington Administrative Code 504-21-010 prohibit WSU’s release of a student’s educational records, other than directory information, without a signed release from the student. The photographs, interview comments, and your name constitute educational records under those laws.

By signing I (we) give Washington State University permission to photograph me (my child) and publish, use, and distribute my (my/our child’s) photographic likeness for promotional and educational purposes. I (We) also grant Washington State University permission to publish, use, and distribute my (my/our child’s) name and/or interview comments for WSU promotional and educational purposes.

Promotional and educational purposes may include use and distribution in print and/or electronic media, including but not limited to publications, books, newspapers, brochures, pamphlets, television, videos, motion pictures, and websites.

This agreement is binding on my (our) successors, assigns, and/or heirs.

1. Public Displays of Affection (PDA)
No kissing, prolonged hugging, or other romantic physical contact during the program.

2. Romantic Pairing
You may not be paired in housing or activities with another camper if you are in a romantic relationship.

3. Sexual Contact or Conduct
No sexual contact, sexual behavior, or sexually explicit conversations (spoken, written, or electronic).

4. Sexualized Discussions
Avoid conversations, jokes, or stories of a sexual nature unless part of a program-approved educational activity.

5. Alcohol or Drugs
No alcohol, cannabis, illegal drugs, or misuse of prescription medication.

6. Respect for Others
No discrimination, harassment, bullying, or hazing. Treat everyone with respect.

7. Safety and Property
Do not endanger yourself or others, disrupt activities, or damage property.

8. Restricted Areas and Equipment
Stay out of areas marked as off-limits and do not use prohibited equipment.

9. Guests
Only parents/guardians or registered program participants may visit you during designated times and in approved locations.

This Camper Code of Conduct is a required supplement to the Washington State University Protection and Safety of Minors policy. It outlines specific behavioral expectations for all participants in programs involving minors. By signing this document, the participant and their parent/legal guardian agree to abide by these rules as a condition of participation. Failure to comply may result in disciplinary action, up to and including removal from the program. All violations will be addressed in accordance with the policy and applicable University procedures.