Basketball Clinic Waiver
Child's Name
*
Grade Level
*
Grade Level
3rd Grade
4th Grade
5th Grade
6th Grade
No elements found. Consider changing the search query.
List is empty.
Parent(s) Full Name
*
Phone
*
Emergency Contact (if different)
Emergency Contact Phone
Important Medical Information (if any)
Medical Treatment Authorization
*
In the event of an emergency, I authorize the clinic staff to seek medical treatment for my child. I understand that every effort will be made to contact me or the emergency contact listed above prior to treatment.
By checking this box, I, the undersigned parent/guardian, acknowledge that participation in basketball and related activities involves an inherent risk of injury. These risks include, but are not limited to, sprains, fractures, concussions, and other potential injuries. I understand and accept these risks on behalf of my child.
By checking this box, In consideration for my child’s participation in the Basketball Clinic, I hereby release and hold harmless Circle W Sports (Showcase), its staff, volunteers, sponsors, and facility operators from any and all liability for injuries, damages, or losses sustained during the clinic. I agree that I am responsible for any medical expenses incurred as a result of participation.
Parent/Guardian Signature
*
Date
*
Submit
Privacy Policy
|
Terms of Service