Basketball Clinic Waiver

Child's Name *

Grade Level *

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 *