Form

Athletes Name

First NameLast Name

Parent/ Guardian

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Grade

RELEASE STATEMENT:

I release Josh Harter and Competitive Edge Basketball Training Program of all liability including injury, death or other damages to me or my child, family, that may result from his/her participation in the program, including but not limited to transportation and hold harmless any of Competitive Edge Training participants, program staff, or other representative, both collectively and individually, of any injury, physical or emotional, other than where gross negligence has been determined.

COMPETITIVE EDGE: MEDIA RELEASE

I give permission for Josh Harter and Competitive Edge Basketball Training to make use of pictures of my son/daughter for informational/advertising purposes only. I hereby release Josh Harter and Competitive Edge Basketball Training and all of its affiliated entities, including employees, volunteers and sponsors for any liability for any damages suffered as a result of or relating to the use of any photographs, slide, audiotape, or videotape of my child done in accordance with the forgoing.

Signature