LILOV FENCING ACADEMY Since LFA Fencing Summer Camps 9 Sand Park Rd, Cedar Grove, NJ /

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1 Dear fencer, Congratulations, you ve made the right choice! We have designed these summer camps for youth, cadet, and junior fencers who understand the importance of working hard in order to make their fencing dreams into reality. These camps are not recreational by design, they re structured to improve your fencing skills utilizing fencing games, speed/agility, and plyometric training. Who is eligible? Any fencer / any level: we ll group fencers based on age and skill level. What about fun? Of course, we thought of it too. Every single activity in the camp will include elements of fun fencing specific games. HOW TO ENROLL? Complete and send us this application by the appropriate due date. 1. Camp Registration 2. Waiver of Liability and consent to treatment Sincerely, Lilov Fencing Academy Team

2 Times: 10am 3pm LILOV FENCING ACADEMY Since 1992 DATES: (Please circle desired date) 6/25/2018 6/29/2018 LFA Pre-summer Nationals camp 7/2/2018 7/6/2018 LFA Duelist Series camp 7/9/2018 7/13/2018 LFA Duelist Series camp 7/16/2018 7/20/2018 LFA Duelist Series camp 7/23/2018-7/27/2018 LFA Duelist Series camp

3 Fencer s Name / Gender / Age: CAMP REGISTRATION USFA Membership Number (all beginners will be required to obtain non-competitive USFA membership for a $10 annual fee): Parent(s) Name: Club / Coach s name / Weapon / Years fenced: Home Address: 3 Emergency Contact Phone #s: 2 addresses (parents): Any medical conditions we should be aware of:

4 LFA Pre-summer Nationals Camp Fees: 5 days: $550 for LFA members, $600 for non-members 4 days: $500 for LFA members, $550 for non-members 3 days: $450 for LFA members, $500 for non-members 2 days: $325 for LFA members, $375 for non-members DEADLINE: May 10 th, 2018 LFA Dualist Series Day Camp Fees: 5 days: $500 for LFA members, $550 for non-members 4 days: $450 for LFA members, $500 for non-members 3 days: $400 for LFA members, $450 for non-members 2 days: $350 for LFA members, $400 for non-members DEADLINE: June 1st, 2018 Please complete all pages of this application and mail a check payable to Lilov Fencing Academy to: LFA, REFUND POLICY: LFA Pre-summer national camp: Payment is due before May 10, No cancellations for any reason after May 10 th LFA Duelist Series Day Camps: Payments are due before June 1st, No cancellation for any reason after June 1 st I agree to the above terms! Parent s Signature: Date:

5 WAIVER OF LIABILITY AND CONSENT TO TREATMENT Camper s Name: Assumption of Risk. I understand that any athletic activity involves physical exertion and risk of injury, and that the sport of fencing involves aggressive physical contact with other participants. I assume the risk of any injury or other medical condition arising as the result of my participation in any athletic and non-athletic activity in which I engage at Lilov Fencing Academy. I understand that it is my responsibility to wear appropriate clothing to all classes, clinics, private lessons, tournaments and open fencing sessions. I understand I am responsible for my own safety and for comporting myself in a safe manner at all times. Consent for Medical Treatment. I certify that on this date I,, give my consent to Lilov Fencing Academy and its representatives to obtain medical care from any licensed physician, hospital or clinic for the above named athlete for any injury or illness that may arise during activities associated with Lilov Fencing. Liability Release. I agree to indemnify and hold harmless, and hereby release, Lilov Fencing Academy (LFA), Lilov Fencing Club LLC and its officers; directors, instructors, coaches, members, guests and other participants, and the United States Fencing Association, from all claims, liability, demands or actions of any kind in connections with my participation in any class, clinic, private lesson, camp, trip, tournament, swimming practices, open fencing, or other activity that I may attend during this summer camp or any other activities sponsored by Lilov Fencing. This includes, but is not limited to, claims, liability, demands, or actions for personal injury or property damage or loss. This agreement also shall be binding on my personal representatives, heirs and assigns. Fencer name: Parent name: Sign name: Date: (a parent or legal guardian must sign if enrollee is under 18 years old)