Basketball Tournament Registration Form

BALLIN N DA BUSH SAFARI CLASSIC Registration Form:

Ellis Park Arena 47 N.Park Lane Doornfontein, Johannesburg, South Africa.

Guest Information

Name*

First NameLast Name

Age*

Guardian / Parents Names*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

E-mail*

Interested in Volunteering while your team is not playing?

CoachOperate Scoreboard

Important Notes ·
Travel Fee: Total: $1908.31 per person.

All parties can book directly with Hyatt House Regency for your hotel accommodations at a rate of 30% less than the cost to book directly with BRIDGE ELITE GLOBAL, for your convenience & savings!!

Included: Hotel accommodations, planned excursions based on itinerary, 3 meals per day, (breakfast, lunch, & dinner), & (1) General Admission game ticket.

We are here to develop our youth through good sportsmanship and quality supervision for educational & employment opportunities. We will assure that the participants will have fun with the game of basketball through our community based initiatives.

Guests accommodations: Hyatt House (Johannesburg SANDTON), Regency Hotels. 125 Ann Crescent, Simba Sandton, 2031, Johannesburg, South Africa. Telephone: +27 10 601 1234

Contact person: Atef Soliman, (Hotel Manager). hyatthousejohannesburgsandton.com

Exclusions: Travel baggage, passports, visas, Hotel phone calls/ bills, any additional meals outside of (breakfast, lunch, & dinner), beginning August 3rd, 2022, gifts or purchases of a personal nature, and or additional excursions outside of the planned group itinerary.

CoVid Protocol for Health & Safety

All guests must have a negative CoVid test within 72 hours of August 6th & 7th, 2022 for the games at Ellis Park Arena or proof of vaccination.

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Do you have health insurance ?

YesNo

Insurance Carrier

Name of Policy Holder

Subscriver ID/Group Number

Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo

Please describe*

Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Release of Liability Although the safety of all sport activities is the primary concern, indoor sport activities while playing basketball at ELLIS PARK ARENA facilities may cause injuries and/or death.
I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against BRIDGE ELITE GLOBAL, BALLIN N DA BUSH SAFARI CLASSIC staff, & Ellis Park Arena staff or the persons in charge.

Any facility issues of negligence or liability knowingly by individuals in management will forfeit the release of liability in the event of any medical situations outside the control of the guests or participants.

I have read and agree to the above conditions*

YesNo

Parent's Signature/ Child's Signature*

Email

example@example.com