Dominican American Basketball Association

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Player Waiver Form

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Email:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

WAIVER, RELEASE AND ASSUMPTION OF RISK: In consideration of my participation in the Dominican-American Basketball Association (hereinafter referred to collectively as “DABA”) ,I hereby waive, release and discharge all claims for damages for death, personal injury, or property damage which may occur as a result of my participation in the DABA league or any activity incident thereto. This release discharges in advance the DABA League, its officers, agents, game officials and referees from liability even though that liability may arise out of the DABA’s active or passive negligence or carelessness. I acknowledge that Basketball may involve an element of risk or danger of accidents, injury and even death, and knowing those risks, I freely and voluntarily assume the risk of injury and/or death and I promise not to sue or exercise any legal right to seek damages from DABA. By this Agreement, I also intend to waive, release and discharge all claims for personal injury, death or property damage caused by the condition of the Courts, lights or any equipment.

I understand that this WAIVER, RELEASE and ASSUMPTION OF RISK form will remain on file with DABA and that it will apply to the current season as well as my participation in future seasons.

I certify that I have no medical condition that would cause participation in DABA to increase the risk of hazard to my health. In addition, I authorize DABA to provide or cause to be provided such medical treatment that may be necessary or appropriate if I am injured while participating in the basketball league.

I hereby consent to the photographing, recording or reproduction in any other manner (including the use of videotapes and audiotapes) of my voice and/or basketball activities and further authorize DABA to make unlimited use of such reproductions, including but not limited to, broadcasting to the public of the reproductions over radio and television stations. I understand that I will not receive any monetary compensation, now or in the future, for participant. I hereby release and hold harmless DABA from any claims that may result from the use of such reproductions.

I have read and understand the rules, guidelines and bylaws of the DABA Basketball League and agree to abide by them. I understand that failure to abide by them may result in my expulsion from the game and or the League.

I/we agree with the above *

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Player Waiver Form