2025 Fire – Ultimate Team Camps

Players Name *

First

Last

School District *

Girls or Boys Team *

Boys Team
Girls Team

Grade *

Players Date of Birth *

Do you need a jersey ordered? *

Yes
No
Not sure yet

Uniform TOP Size – (Under Armour – Girls seem to run a little small)

Uniform SHORTS Size – (Under Armour – Girls seem to run a little small)

Preferred Uniform Number(s) – Please note every attempt will be made to get a preferred number; not guaranteed

Player Phone Number

Email *

Parent/Guardian Name *

First

Last

Parent/Guardian Phone Number *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

HEALTH & GENERAL HISTORY: Should the player be restricted from any activity please note: *

Please identify any medical condition or medical history that would require special attention: *

AAU Payment 10u-11u *

Player Fee – $450.00
Jersey – $55.00
Shorts – $50.00
I will pay in full at tryouts (cash, check, Venmo or credit card) – $0.00

A credit card fee will been added to the total. This is a banking fee we, unfortunately, have no control over. If paying by Venmo or Check/Cash, please use the total listed. No fees are added….THANK YOU!

AAU Payment 12u-17u *

Player Fee – $625.00
Jersey – $55.00
Shorts – $50.00
I will pay in full at tryouts (cash, check, Venmo or credit card) – $0.00

A credit card fee will been added to the total. This is a banking fee we, unfortunately, have no control over. If paying by Venmo or Check/Cash, please use the total listed. No fees are added….THANK YOU!

Intended Payment Option *

Credit Card
Venmo @UltimateTeamCamps
Mail to: UTC, 1540 Brookhaven Way, Plover, WI 54467
Paying at or shortly after tryouts

Credit Card Fee – Player Registration

Price: $15.00

Total

$0.00

Square *

Card

Name on Card

Signature *

Clear Signature

As the parent (guardian) of the named player I give permission to receive emergency medical or surgical treatment and hospitalization if necessary. I understand that every attempt will be made to contact me, or the emergency contact named above, before taking this action. I will be financially responsible for any medical attention needed during time with UTC or resulting from an injury received playing. My medical insurance shall be the insurance coverage for any medical treatment. I further agree that my child can receive over-the-counter remedies if necessary. (Tylenol, Sudafed, etc.) Please give special instructions above if you do consent to your child receiving over-the-counter medications. I HAVE READ THE POLICIES AND FULLY UNDERSTAND MY OBLIGATIONS STATED THEREIN AND ALSO THE RIGHTS OF Ultimate Team Camps, AND HERBY AGREE TO ACT IN ACCORDANCE. I also agree that my child may be transported by bus and/or camp vehicle to an off-site medical center or for emergency medical treatment. The undersigned further expressly agrees that the attached waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. In consideration of my minor child/ward (“my child”) being allowed to participate in UTC Fire or any UTC Event, its related events and activities, I, the undersigned, acknowledge, appreciate, and agree that: 1. The risk of serious injury from the sports activities involved in this program is always present due to the nature of the sport (s); and 2. FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child’s participation; and 3. I willingly agree to comply with the program’s stated and customary terms and conditions for my child’s participation. If, however, I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from participation and bring such to the attention of the nearest official immediately; and 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the Camp, Ultimate Team Camps, its affiliates, officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for activity (“Releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, regarding my child and/or arising from his/her activities, WHETHER ARISING FROM NEGLIGENCE OF THE RELEASEES OR OTHERWISE, except for willful misconduct, or otherwise to the fullest extent of the law. I HAVE READ THIS HEALTH FORM AND RELATED CERTIFICATIONS, THE RELASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND THEIR TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.