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REGISTER for 2025 AAU Spring/Summer Season

PLAYER INFORMATION

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

MEDICAL/EMERGENCY CONTACT INFORMATION
WAIVER INFORMATION
As parent/guardian of Athlete, with legal custody and control over Athlete, and with the authority to do so, I hereby give permission for Athlete to voluntarily participate in organized athletics at Lindenwold Youth Basketball Association.

I am aware that it is strictly voluntary for Athlete to participate in organized athletics at LYBA. I am aware that trying out for, practicing, or playing any sport can be a dangerous activity involving many risks of injury. I realize and understand the inherent potential dangers and risks of trying out for, practicing, and playing in any athletics, including injuries that may be catastrophic in nature and may include, but are not limited to, death, serious neck or spinal injuries, complete or partial paralysis, brain damage, serious injury to virtually all bones, joints, ligaments, muscles, tendons, and other elements of the muscular-skeletal system, including loss of limb, as well as serious injury or impairment to any other part of the body, and to Athlete?s general health and well-being.

I certify that to the best of my knowledge, Athlete is in good health and suffers no disability or condition which renders his or her participation in competitive athletic activities medically inadvisable or otherwise limits his or her ability to participate in such athletic activity without restriction. Furthermore, I certify that Athlete does not require any special accommodations or modifications to participate in competitive athletics.

I am aware of, and on behalf of Athlete, I hereby acknowledge and voluntarily assume all risk to Athlete (including without limitation those risks set forth herein above, and any other risks of accident, injury, death, illness, damage and destruction) arising from his or her participation in athletic activities. Furthermore, on behalf of Athlete, I assume such risks regardless of their causes, which may include, but are not limited to the failure to enforce or comply with any federal, state, local, or other laws, rules or regulations; the failure to inspect equipment, personnel or facilities; the failure to maintain equipment or facilities in a reasonable manner; the failure to supervise any persons; the traveling to and from any practice, game, seminar or training demonstration site; and the negligence of others, including specifically but not limited to the negligence of LYBA, its trustees, officers, administrators, employees, coaches, representatives, affiliates, agents, students, successors and assigns.

In consideration for LYBA allowing Athlete to try out for, practice, play, or otherwise participate in competitive athletics and to engage in all activities related to his or her participation in athletic activities and membership on a team, including but not limited to practicing, playing, and traveling, I hereby voluntarily assume all risk associated with Athlete?s participation and agree to release, waive, indemnify, defend, and hold harmless LYBA, its trustees, officers, administrators, employees, coaches, representatives, affiliates, agents, insurers, successors and assigns, from and against any liability , claims, causes of action or demands of any kind and of any nature whatsoever, which may arise by or in conjunction with Athlete?s participation in any activities related to LYBA athletics, including but not limited to practicing, playing, or traveling, or in conjunction with Athlete?s use of LYBA?s facilities or equipment.

I certify that I have adequate medical or health care insurance that covers Athlete and that will cover any medical assistance that Athlete may require as a result of his or her participation in athletic activities and acknowledge that Athlete is not covered by any insurance policy maintained by LYBA.

I have carefully read this Waiver of Liability, Assumption of Risk, & Indemnity Agreement (?Agreement?). I fully understand its contents, voluntarily sign it, and realize that it is binding upon me, Athlete, my heirs, successors, personal representatives and assigns. I recognize and acknowledge that this Agreement means that I am giving up, among other things, rights to bring suit against LYBA, its trustees, officers, administrators, employees, coaches, representatives, affiliates, agents, insurers, successors, and assigns for any injuries, damages, or losses that Athlete or I may incur through Athlete?s participation in competitive athletics, regardless of the cause.

By signing below, I acknowledgment that all of the information in this Agreement is correct and agree that this Agreement is valid and binding from the date signed and continues during any and all participation by Athlete in any LYBA athletic activities.

 

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