Hill Country Youth Services AAU Boys and Girls Basketball & Volleyball Club

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CLOOSED SOLD OUT 2017 RISE UP SUMMER SHOWCASE JULY 222ND

TEAM INFORMATION

* TEAM Name:

* COACH Name:

ASST COACH Name:

City:

State:

Zip Code:

* GRADE LEVEL:

* TEAM GENDER:

* GRADE LEVEL YOU WISH TO PLAY IN:

EMail:

Home Phone:

Work Phone:

Cell Phone:

WAIVER INFORMATION

PARTICIPANTS’ RELEASE AND WAIVER OF LIABILITY

In consideration of my child’s participation on the Liberty Hill Wildcats Youth Basketball Team hereby grants to the Coach the right to record, broadcast and otherwise exploit in any and all media my child’s performance while playing and to participants name, likeness, voice and biographical information concerning my child in connection therewith.

I understand that acceptance of our child’s entry in this basketball program is without responsibility of any kind by the Coach Edward Beans, any other entities sponsoring or contributing to the program., on my child’s behalf, do hereby for on behalf of ourselves and our heirs and legal representatives and our child RELEASE and forever discharge the Coaches and any other entities or representatives of such entities sponsoring or contributing to the program from any and all claims, demands and injuries howsoever arising, whether caused by the negligence or intentional acts of the Coaches and its representatives and any other entities or representatives of such entities sponsoring or contributing to the program, or by third parties, which injuries may be in any way related to my child’s activities during the program and any period traveling to or from the program described and all such claims are hereby WAIVED AND RELEASED, and I on behalf of my child, covenant not to sue therefor.

THE PARENT[S] OR GUARDIAN[S] BY CLICKING ON THE “ I ACCEPT” BUTTON DOES HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS THE COACHES, EDWARD BEANS AND HIS REPRESENTATIVES, AND ANY OTHER ENTITIES SPONSORING OR CONTRIBUTING TO THE PROGRAM FROM ANY LIABILITY WHICH THEY MAY INCUR TO THE CHILD THAT THIS FORM REPRESENTS, HOWSOEVER ARISING AND WHETHER CAUSED BY THE NEGLIGENT OR INTENTIONAL ACTS OF THE COACHES, OR ANY OTHER ENTITIES SPONSORING OR CONTRIBUTING TO THE PROGRAM OR THIRD PARTIES.

I/we agree with the above *

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CLOOSED SOLD OUT 2017 RISE UP SUMMER SHOWCASE JULY 222ND