Carolina Knights Basketball Club

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Player Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Cell Phone:

* Birthdate:

* Email:

* Grade:

* Gender:

* Height:

* Uniform Size:

* School:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

The undersigned Player (or parent or legal guardian of a minor player ) states and agrees as follows:

The undersigned agrees that player voluntarily participates in playing basketball and assumes all risks associated with such play.
The undersigned acknowledges that there are risks and hazards in playing basketball including, but not limited to, those caused by court
Conditions, playing conditions, equipment and other participants, in addition to the acts of dribbling, passing, shooting, and dunking a
Basketball, running, jumping, stretching, sliding, diving and collisions with other players, spectators, or stationary objects, any of which may
Cause death or serious injury to the player.
In consideration of the Carolina Knights Basketball Club allowing play on the courts rented, operated, or used by the Carolina Knights Basketball Club, I AGREE TO
INDEMNIFY AND HOLD HARMLESS AND RELEASE the Carolina Knights Basketball Club and their officials, employees, agents and assigns from any and all claims, demands, lawsuits, costs and attorneys fees arising out of playing in the Club's program listed above.
This release and Indemnification shall be effective and bind any and all heirs, dependents, executors, and assigns.
I ACKNOWLEDGE THAT I HAVE THE RIGHT AND OBLIGATION TO INSPECT the Court and areas surrounding prior to each game
and agree to play in the “as is” condition. If I find the court is not safe, I have the right to choose not to play.
I acknowledge that I have read the foregoing instrument and understand its terms and agree to abide by its terms and conditions.

I/we agree with the above *

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