Cardinals in Command: A Business Camp for Future Leaders

Monday, June 16, 2025 at 9:00 AM until Wednesday, June 18, 2025 at 4:00 PMCentral Daylight Time UTC -05:00

Galloway Business
4400 South Martin Luther King Junior Parkway
Beaumont, TX 77705
United States

Camper Information

Camper First Name

Camper Last Name

Camper Preferred Name

Camper Birthdate

Camper Race

Camper Ethnicity

Camper Gender

Camper Email Address

Camper Phone Number (Please list student phone number, parents will be entered further down)

Can we text you?

Yes

Mailing Address

Country

Street

City

Region

Postal Code

Academic Information

Admission Type (Hidden)

What grade will you be in during the 2025 - 2026 academic year?

Do you know what you're interested in studying?

When do you plan to enroll in college?

Are you on the Honor Roll at School?

Are you a member of National Junior Honor Society or National Honor Society?

School Name (type in to search)

What type of school do you attend?

Parent Information

Relationship

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Preferred Phone Number

Parent/Guardian Email

Would you like to list a second parent/guardian?

Relationship

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Preferred Phone Number

Parent/Guardian Email

Activity and Indemnity Agreement

This release is required by Lamar University. Campers will not be able to attend unless this is completed.

Is the participant under the age of 18?

First and Last Name of Parent/Guardian:

Relationship to Minor Participant:

Activity:

This is a Release of Liability, Indemnification and Assumption of Risk Agreement. Read it carefully and sign below. Completion of this form is required before the above-named Minor participates in the Activity. This document cannot be altered or modified by any verbal or written statements.

Releasees:

The “Releasees” in this agreement are the Board of Regents, The Texas State University System, Lamar University, and all regents, directors, employees, agents, and officers and volunteers of such entities.

Assumption of Risks:

To the best of my knowledge, the above-named Minor is in good health and has no physical limitations that would preclude or impede the above-named Minor’s participation in the Activity listed above (hereafter Activity). I am aware of the risks, perils and hazards connected with the Activity. I acknowledge that loss of property, personal or bodily injury, or death might result from the Activity and/or the acts of others. I voluntarily elect to allow the above-named Minor to participate and engage in the Activity knowing that the Activity may be hazardous to my property, the above-named Minor’s property and the above-named Minor. I voluntarily and expressly agree and promise that I assume full responsibility for property loss or damage, and for personal injury, including death, that I or the above-named Minor may sustain as a result of being engaged in the Activity, whether or not based on the negligence or other wrongful conduct of any of the Releasees.

Indemnification:

I ALSO AGREE TO INDEMNIFY, PROTECT, DEFEND (ON Initial DEMAND), AND HOLD HARMLESS THE RELEASEES FROM ANY AND ALL LOSS, LIABILITY, DAMAGE, OR COSTS OF ANY NATURE WHATSOEVER, WHETHER NOW EXISTING OR HEREAFTER ARISING, INCLUDING WITHOUT LIMITATION COURT COSTS AND ATTORNEY’S FEES, THAT THE RELEASEES MAY INCUR DUE TO THE ABOVE NAMED MINOR’S PARTICIPATION IN THE ACTIVITY WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERWISE. FOR EXAMPLE, I SPECIFICALLY AGREE TO INDEMNIFY, PROTECT, DEFEND (ON DEMAND) AND HOLD HARMLESS THE RELEASEES FROM ANY LOSSES THE RELEASEES MAY INCUR AS A RESULT OF THE ABOVE-NAMED MINOR’S INJURIES OR DEATH, AND/OR THE ABOVE-NAMED MINOR INJURING ANOTHER PERSON OR DAMAGING ANOTHER PERSON’S PROPERTY WHILE PARTICIPATING IN THE ACTIVITY. THE INDEMNITY OWED BY ME AS SET FORTH HEREIN IS SPECIFICALLY INTENDED TO INCLUDE CLAIMS CAUSED, OR ALLEGED TO HAVE BEEN CAUSED, IN WHOLE OR IN PART, BY THE RELEASEES’ OWN NEGLIGENCE.

Release:

In consideration for facilitating the above-named Minor’s participation in the Activity I, individually and as the parent/guardian of the above- named Minor, release, discharge, and agree not to sue any of the Releasees for any claims, demands, actions, and causes of action of any nature whatsoever including without any limitation any claims of negligence, arising out of any loss or damage to my or the above- named Minor’s property and/or any personal injury or death, that the above-named Minor may sustain whether or not caused by the negligence of any of the Releasees, while participating in the Activity, whether supervised or unsupervised, or while in transportation to or from the Activity. THE RELEASE, DISCHARGE, AND COVENANT NOT TO SUE SET FORTH HEREIN IS SPECIFICALLY INTENDED TO INCLUDE CLAIMS CAUSED, OR ALLEGED TO HAVE BEEN CAUSED, IN WHOLE OR IN PART, BY THE RELEASEES’ OWN NEGLIGENCE.

Intent:

I intend that this Release of Liability, Indemnification and Assumption of the Risk Agreement bind not only me, but also the members of my family and my spouse, and my heirs, assigns, and personal representatives. I intend this as a release, discharge, and promise not to sue the Releasees. I further agree that this Release of Liability, Indemnification and Assumption of the Risk Agreement should be construed in accordance with the laws of the State of Texas.

Free Act:

I acknowledge that I have read and understand this Release of Liability, Indemnification and Assumption of Risk Agreement and understand that it is legally binding. I understand it and sign it voluntarily as my own free act.

Disclaimer and Signature:

I certify that I am the parent and/or legal guardian of the above named minor participant, of lawful age (18 years or older) and legally competent to sign this agreement.

Parent/Guardian Typed Name (serves as signature):

Authorization and Release for use of Name, Image, or Likeness

Releasees: The Texas State University System Board of Regents, Lamar University, their administrators, employees, representatives and agents. (Lamar)

Consent: For good and valuable consideration, I hereby grant to Lamar full and complete rights to the use of my image (still photograph or video), with or without the use of my name, in print and electronic publications or productions promoting Lamar, The Texas State University System, its colleges and/or programs. This release is given without charge to or any remuneration from Lamar.

I authorize Lamar to (a) record my likeness and voice on a video, audio, photographic, digital, electronic or any other medium; and (b) use my name in connection with these recordings. I hereby irrevocably assign, transfer, release and convey to Lamar, in perpetuity, throughout the universe, a nonexclusive and royalty-free license to use the recordings above, as well as all intellectual property rights embodied in or pertaining to any of the foregoing and the complete right to exploit or otherwise use those recordings, in any form of medium, expression or technology now known or hereafter known or developed.

I waive the right to inspect or approve any reproduction of my physical likeness or voice or my voice recording, and I release and discharge Lamar and Board of Regents, officers, agents and employees from all claims in connection with the use of my physical likeness, voice, and name.

I further acknowledge that my participation is voluntary and that I will not receive financial compensation of any type associated with the taking or publication of these photographs or participation in company marketing materials or other University publications. I acknowledge and agree that publication of said photos or videos confers no rights of ownership or royalties whatsoever. I understand that all recordings, in whatever medium, shall remain the property of Lamar.

Release: I hereby release and hold Lamar free and harmless from any claims of copyright, libel, slander, invasion or violation of privacy or other similar rights that I may hold or assert. I release Lamar and those acting pursuant to its authority from any and all liability for any violation of any personal, intellectual or proprietary right I may have in connection with such use by Lamar. I intend this Release also to bind the members of my family, my heirs, assigns and personal representatives. This release includes all claims, whether or not caused by Lamar’s negligence.

Indemnity: I also agree to indemnify and hold Lamar harmless from any loss, damage, liability, or costs that they may incur from the university’s use of my image, name, or voice.

I understand that all such recordings, in whatever medium, shall remain the property of Lamar. I have read and fully understand the terms of this release.

Camper First and Last Name (serves as electronic signature)

CONSENT OF PARENT/LEGAL GUARDIAN REQUIED IF ABOVE INDIVIDUAL IS A MINOR:
I am the parent and/or legal guardian of the above minor and hereby consent and agree to the foregoing terms and provisions on his/her behalf.
Parent/Guardian Typed Name (serves as signature):

Parent/Guardian Authorization, Waiver, & Consent for Over-the-Counter Medication

Over-the-Counter (OTC) Medication may at times need to be administered, if approval is indicated by the student’s parent or guardian. Please complete the following section to save time if your child needs any of these OTC medications during her/his stay. Note: Unless we have parental authorization, we cannot administer ANY medications.

I hearby authorize that the following medications may be given to my camper if the need arrises. Please check all boxes below that we may dispense.

Ointments for minor wound care, first aid as directed. (Antiseptic, anti-itch, anti-sting, antibiotic, sunburn)

Tylenol/Acetaminophen as directed

Throat lozenges and/or spray as directed for sore throat

Kaopectate or Imodium for diarrhea as directed

Rolaids or Tums for acid reflux, heartburn, or indigestion as directed

Actifed or Sudafed as directed for nasal congestion or allergy relief per instructions

Medicated lip ointment for dry, chapped lips, lip blisters, or canker sores as directed

Hydrocortisone ointment as directed for mild skin irritations, poison ivy, and insect bites

Robitussin or other cough syrup as directed

Sunscreen

Ibuprofen as directed

Micatin or anti-fungus treatment as directed for athlete's foot

Milk of Magnesia, Pepto Bismol, or Mylanta for upset stomach or nausea as directed

Benadryl for swelling, hives, allergic reaction, as directed

Visine or other eye drops for minor eye irritation

Swimmer's ear drops as directed

Medicated powder for skin irritation as directed

Calamine lotion for bug bites and poison ivy

Bug repellent

None of the above

Program staff reserve the right to use generic equivalents when available for the name brand over-the-counter medications listed above. I understand that such administration will not be done under the supervision of medical personnel. I also agree that any first aid treatment may be given as needed. I understand that these over-the-counter medications are not necessarily kept on hand and available to be administeredimmediately.

Any condition which is associated with fever, significant inflammation, and/or does not respond to the above outlined treatment will be followed-up by a consultation with the student’s parents. Parent/guardian will be contacted if any conditions develop requiring treatment with any of the above over-the-counter medications that are not checked.

I authorize the administration of over-the-counter medications to my child as indicated above. I shall indemnify, release, and hold harmless for any all purposes Lamar University, The Texas State University System, thereregents,employees, officers, directors, members, servants, agents, and volunteers (RELEASEES) against any claims that may arise relating to my child being administered the above indicated over-the-counter medications including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of RELEASEES.

Does the camper have any allergies?

What are they allergic to?

I/We have legal authority to consent to medical treatment for the participant named above, including the administration of medication at the program hosted by/at Lamar University.

Yes

Camper First and Last Name

Parent/Guardian Typed Name (serves as signature):