Rising Stars Basketball - Registration & Waiver Forms

Rising Stars Basketball

Player Registration & Waiver Forms
I, the undersigned, First Name Last Name , parent legal guardian*of the child named First Name Last Name , wish to enroll my child to Rising Stars Basketball.
Date of Birth of the Athlete:*

MonthDayYear
Date
Current Grade of Athlete:*
Current School of Athlete:*
Grade of Athlete:
Current Height of Athlete:
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent #1 /Legal Guardian #1 - Phone Number:*
May Be Used For Texting & Emergencies
Parent #2 /Legal Guardian #2 - Phone Number (If Applicable)
May Be Used For Texting & Emergencies
Parent #1 / Legal Guardian #1 E-mail:*
example@example.com
Parent #2 / Legal Guardian #2 E-mail:
example@example.com
Athletes Cell Phone Number: (If Applicable)
Athletes Primary Care Physician Name:*
Athletes Email: (If Applicable)
Athletes Primary Care Physician Phone Number:*
Does The Athlete Have Any Allergies Or Pre-Existing Conditions?:*
By signing this School Sports Clinic Enrollment Form on Date* , I hereby confirm that the information given in this form is accurate and complete.
Signature

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*WAIVER AND RELEASE OF LIABILITY*

All-Net Rising Stars Incorporated

ASSUMPTION OF RISK AND AGREEMENT FOR RISING STARS BASKETBALL

READ THIS DOCUMENT COMPLETELY BEFORE SIGNING. IT RELEASES RISING STARS BASKETBALL AND EMPLOYEES FROM ANY LIABILITY RESULTING FROM YOUR CHILD'S PARTICIPATION IN RISING STARS ACTIVITIES DESCRIBED BELOW AND WAIVES ALL CLAIMS FOR DAMAGES OR LOSSES AGAINST RISING STARS WHICH MAY ARISE FROM SUCH ACTIVITIES, EXPRESSING ASSUMPTION OF RISK ASSOCIATED WITH PARTICIPATION IN THE SPORTS ACTIVITY.

   I, signee do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with my child's participation offered by Rising Stars. This Agreement shall be binding upon my child and myself and shall be applicable to and remain in effect for so long as I choose to have my child participate in the Rising Stars program. I understand and acknowledge that the risks and hazards inherent in the activities associated with my child's participation may include personal injuries that range from relatively minor injuries to severe permanent personal injury.

         Despite the potential risks, hazards, and dangers associated with my child's participation in any intramural sport, I wish for my child to participate and freely accept and expressly assume all risks, dangers and hazards that may arise from my child's participation which could result in temporary or permanent personal injury.

         I acknowledge and agree that both my own and my child's participation in Rising Stars is not coerced or compelled and is solely a matter of personal interest. My child and I are participating voluntarily, knowing it may result in injury to my child, others, or myself.

         I also realize that Rising Stars the first month is on a try out basis. If we feel that your sons is not a right fit in our program within that time we have the right to remove them from the program. If that does come about, parents refunds will be prorated.

I understand that Rising Stars is involved in social media and posts photos of players in a positive manner. If I DO NOT want my son's picture ever posted on social media, I will email Michael Buller before their first practice and we will not include your son in any forms of social media.

         All financial refunds are issued in a prorated manner. Meaning if a player discontinues Rising Stars Basketball. You will be refunded on a prorated basis. Refunds will always made at the disgretion of Mr. Michael Buller.

         *I HEREBY DECLARE that I am of legal age and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT. I AM SIGNING BY ELECTRONIC SIGNATURE.
Signed By Parent Or Guardian Named Parent / Guardian Name* .
Signing For Athlete Athlete Name* .
Today's Date:*

MonthDayYear
Date
Parent / Guardian Signature:*

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WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

In consideration of being allowed to participate on behalf of All-Net Rising Stars Incorporated athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1.     Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

2.     I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3.     I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4.     I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Rising Stars Incorporated & their officers, coaches, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

FOR PARTICIPANTS OF MINORITY AGE

(UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
Signed By Parent Or Guardian Named Parent / Guardian Name* .
Signing For Athlete Athlete Name* .
Today's Date:*

MonthDayYear
Date
Signature*

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