2018 Golf Camp | Application for Summer Youth Camps

Does your child have any medical conditions such as; asthma, diabetes, anaphylaxis, food allergies or any other condition?

MEMBERS: I hereby apply for enrollment for my son, daughter, or grandchild(ren) in the Golf Camp at Lakeside Country Club. I, or we, hereby authorize the appropriate fees for the member child or grandchild be charged to my account.

Guests of Members:
I hereby apply for enrollment for my son and/or daughter for the Golf Camp at Lakeside Country Club. I, or we, hereby authorize the appropriate fees for the guest child. Guest fees must be billed to a member sponsor account.

In signing this application, I certify that my child is in good physical condition and I, or we hereby agree to hold Lakeside Country Club harmless from all liability and to fully indemnify them for any claim, or claims, or damage they are caused to pay for reason of claim, or claims, by my child or children. Let this signing also serve as permission for my child, or children, to travel with the Lakeside Country Club
Program on any outings away from the Club on a specified day to be announced.

This application has my approval and consent.

Enter "Guest" above if you are a guest of a member.
* In the event this application is for a grandchild of a Member, the signature of a parent of the child is also required. Please include contact info of Grandparent(s) in case of emergency as well.


In consideration, the receipt and sufficiency of which is hereby acknowledged, for being allowed entry and use, or his/her minor child/children, of the Outdoor Area, which includes, but is not limited to a zip line and climbing tower (the “Activities”) at Lakeside Country Club (the “Club”), to the fullest extent permitted by law, the undersigned, individually and on behalf of his/her family, heirs, administrators, executors and assigns, hereby enters into this RELEASE OF LIABILITY AND INDEMNITY AGREEMENT (this "Agreement").

1. ACKNOWLEDGMENT OF RISKS: The undersigned recognizes and understands that there are risks associated with his/her participation, or his/her minor child/children participation, in the Activities including, but not limited to, bodily injury or death.

2. RELEASE FROM LIABILITY: The undersigned hereby RELEASES, ACQUITS AND FOREVER DISCHARGES and shall DEFEND, INDEMNIFY AND HOLD HARMLESS Club, and its present and former directors, officers, employees, agents and representatives and their respective heirs, administrators, executors, successors and assigns (collectively, the "Club Parties") from any and all claims, causes of action, suits and/or demands for bodily injury, death, or property damage accrued or to accrue in the future, known or unknown, (collectively "Claims") relating to or arising out of any negligent, grossly negligent and/or intentional or unintentional acts on the part of the Club Parties in connection with his/her participation in the Activities, including any Claims of my minor child/children. Without limiting the foregoing, the undersigned agrees that the Club Parties shall not be liable to him, her, his/her family, heirs, administrators, executors or assigns for Claims arising from or related to his/her participation in the Activities as well as his/her minor child/children.

3. AGREEMENT TO DEFEND, INDEMNIFY AND HOLD HARMLESS: The undersigned agrees to DEFEND, INDEMNIFY and HOLD HARMLESS THE CLUB PARTIES AGAINST THE CONSEQUENCES OF THE CLUB PARTIES' OWN NEGLIGENCE, REGARDLESS OF WHETHER SUCH NEGLIGENCE WAS THE SOLE, PROXIMATE OR PRODUCING CAUSE OF ANY CLAIM OF THE UNDERSIGNED OR CLAIM MADE BY, THROUGH OR ON BEHALF OF THE UNDERSIGNED MINOR CHILD/CHILDREN; provided, however, that the duty of the undersigned to defend, indemnify and hold harmless the Club Parties shall extend only to claims arising directly or indirectly from the his/her participation in the Activities as well as his/her minor child/children. As used herein, "INDEMNIFY" means to agree to assume the Club Parties' liability, thereby relieving the Club Parties' responsibility and/or reimbursing the Club Parties for Claims asserted against them.

4. As further inducement to Club to permit the undersigned, as well as his/her minor child/ children, participation in Activities, the undersigned represents that he/she thoroughly and completely understands this is a complete and final release and indemnity agreement, that he/she is freely and voluntarily entering into this Agreement, and that no representations, promises or statements made by the Club Parties, or any agent, attorney or other representative of Club Parties has influenced the undersigned in causing him/her to sign this Agreement. The undersigned understands that this Agreement shall be binding on his/her heirs, executors, successors and assigns, and that this Agreement will be governed by the laws of Texas, and that jurisdiction and venue for resolution of any dispute regarding this Agreement shall lie in a Texas State Court in Harris County, Texas. If any part of this Agreement is determined to be invalid or unenforceable, it does not affect the validity of the remainder of this Agreement. The undersigned agrees to the terms and conditions above, and acknowledges receipt of this Agreement.

* Denotes Required Field
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