Basketball Summer Camp Registration

Summer Basketball camp will be hosted for 3 different weeks.

Week 1- June 7-9

Week 2- June 12-16

Week 3- June 19-23

Drop off 8:30 a.m  Pick up 3:00 PM*

Address: 71 Mid Cape Terr #5 Cape Coral, Fl 33991

 

*Early Drop off at 8:00 AM for $15*

**$15 Pick up Late Fee implented for anything past 3:15 PM. Thank you for being considerate. 

 

***No refunds given for camp registration***

***No refunds given for camp registration***

***No refunds given for camp registration***

Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by HOOPS ON MISSION during the selected camp. In exchange for the acceptance of said child’s candidacy by  HOOPS ON MISSION ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless HOOPS ON MISSION. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against  HOOPS ON MISSION . including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

In consideration of being allowed to participate in any way in the HOOPS ON MISSION programs, related events, and activities, the undersigned, on behalf of myself and my participating children or guardians, acknowledge, appreciate, and agree that: I am aware there are risks to me of exposure to directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof.

Participation in HOOPS ON MISSION programs, events, and activities involves the potential exposure to, and illness from infectious, communicable diseases, including COVID-19. While following Federal and State guidelines, FLORIDA STATE GUIDELINES and HOOPS ON MISSION COVID-19 Protocol may reduce the risk, THE RISK OF SERIOUS ILLNESS AND DEATH DOES EXIST. HOOPS ON MISSION CANNOT, AND DOES NOT GUARANTEE, WARRANT, OR REPRESENT THAT PARTICIPANTS WILL NOT CONTRACT A COMMUNICABLE DISEASE, INCLUDING BUT NOT LIMITED TO COVID-19, AS A RESULT OF PARTICIPATION IN ITS PROGRAMS, EVENTS, OR ACTIVITIES.

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, HOLD HARMLESS, AND FOREVER DISCHARGE HOOPS ON MISSION, its officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, liability, rights, or causes of action of whatsoever kind arising out of, or in any way connected to or related to any ILLNESS, INJURY, DISABILITY, DAMAGES OR DEATH I may suffer or sustain as a result of my participation in HOOPS ON MISISON CAMP, events or activities, WHETHER ARISING FROM THE NEGLIGENCE OF THE 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, ACKNOWLEDGE THAT IT CONSTITUTES A BINDING AGREEMENT AND PROMISE, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Medical Release and Authorization As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Hoops on Mission. and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.