RBL Hold Harmless & Consent

2026 Reach Basketball League Participation Agreement
Reach Basketball Participation Agreement

Shiloh Road Church of Christ
1801 Shiloh Road, Tyler, Texas 75703
903.561.7992

Reach Bosketball League 2026
March 21, March 28, April 4, April 11
PARTICIPANT INFORMATION - ONE FORM PER FAMILY

A supervising adult must remain on-site.
Name of player 1

First NameLast Name
Name of player 2

First NameLast Name
Name of player 3

First NameLast Name
Name of player 4

First NameLast Name
Name of Parent/Guardian:

First NameLast Name
Phone
Format: (000) 000-0000.
List allergies or medical conditions (include first name if multiple players)
I acknowledge that participation in the activity described above involves risk to the participant(s) & to the participant's parents or guardians, and may result in various types of injury. In consideration for the opportunity to participate in Reach Basketball, the participant's parent/guardian acknowledges and accepts the risks of injury associated with participation in the activity. The participant's parent/ guardian accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment provided to the participant(s) that is authorized by Shiloh Road Church of Christ or its agents, employees, volunteers, or any other representatives. Further, the participant's parent/guardian releases and promises to indemnify, defend, and hold harmless Shiloh Road Church of Christ for any injury arising directly or indirectly out of the described activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant's parent/guardian agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant's parent/guardian and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.
Signature

Clear
Date
PHOTO/VIDEO AUTHORIZATION OF A MINOR

The undersigned, being the parent or legal guardian of the child(ren) listed above do hereby authorize the staff members, agents, & employees of Shiloh Road Church of Christ to photograph or film my student. The undersigned authorizes Shiloh Road Church of Christ permission to the use & display any photographs and/or videos in publications, multimedia productions, displays, advertisements, training materials, or internet publication related to the promotion of Shiloh Road Church of Christ or in the promotion of any activities supported by Shiloh Road Church of Christ. The undersigned agrees that Shiloh Road Church of Christ may use name & likeness supplied by the undersigned. The undersigned releases and forever discharges Shiloh Road Church of Christ & its staff members, agents, & employees from any & all claims & demands arising out of or in connection with the use of said photographs/images, including but not limited to, any claims for invasion of privacy or deformation.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

2026 Reach Basketball League Participation Agreement

PARTICIPANT INFORMATION - ONE FORM PER FAMILY