| I/We the undersigned parent(s)/guardian(s) certify that Camper has been examined by a licensed physician within the school year of 2012 – 2013 and according to physician, is free from any illness, injury or condition which would limit participation in the activities conducted by the Jim Kelly Football Camp, Inc. (JKFC) I/We also confirm that all the above information is complete, accurate and correct to the best of my/our knowledge. I/We also hereby authorize the staff of JKFC to act in my/our behalf and for me/us according to their best judgment in a situation requiring first aid or medical attention for Camper. If such a situation arises, I/we authorize said persons to request pertinent medical information on my/our behalf and I/we hereby release those providing such information from any liability that might result. I/We hereby recognize that, although JKFC is a non-contact instructional endeavor, participation requires strenuous physical activity, which can result in unintentional contact and exposure to injury, impairment or the aggravation of any preexisting condition (s). I/We hereby release, discharge, hold harmless and promise to indemnify Jim Kelly, JKFC and its sponsors and staff, Jim Kelly Inc., Buffalo Bills, St. John Fisher College, and their trustees, officers, employees and agents from any and all causes, liabilities, damages, claims or demands whatsoever on account of any injury (including death) or accident involving Camper arising out of Camper's participation in the 2013 Jim Kelly Football Clinic. I/We authorize JKFC to use any camper photographs taken to be used for promotional purposes. JKFC reserves the right, in its sole discretion, to accept or not accept any application for enrollment. The full deposit will be returned accompanying any application, which is not accepted for whatever reason. It is the intention of JKFC to exercise its discretion in this regard with a view to the health and safety of all camp participants.