Basketball Toy Drive For Autism and Special Needs. 4:30PM-6:00PM
Saturday December 7th - Location: 4141 Bailey Rd. Pearland, TX 77584
Email
*
example@example.com
Name of Event
*
Participant's Name
*
Gender
*
Male
Female
Other
Race
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
White
Other
Date of Birth
*
-
Month
-
Day
Year
Parent/Guardian Name
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Home Address
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Phone
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Alternate Number
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Please enter a valid phone number.
Any medical conditions or food allergies?
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Emergency Contact Number
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School
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Grade
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T-Shirt Size
*
XS
S
M
L
XL
XXL
THE PARENT/GUARDIAN OF THE ABOVE NAME CHILD, HEREBY GIVE MY APPROVAL OF HIS/HER PARTICIPATION IN ALL BASKETBALL/SPORTING ACTIVITIES. I ASSUME ALL RISKS AND HAZARDS INCIDENTAL TO SUCH PARTICIPATION. I DO HEREBY WAIVE, RELEASE, ABSOLVE AND AGREE TO HOLD THIS FACILITY AND BE A NINTH WONDER FOUNDATION, INC, COACHES AND OFFICIALS FROM ANY CLAIMS WHICH MIGHT ARISE FROM INJURIES SUSTAINED WHILE PARTICIPATING IN THIS EVENT. PICTURES AND VIDEOS WILL BE TAKEN DURING EVENTS. THEREFORE I/WE THE PARENT/GUARDIAN OF THE ABOVE NAME PARTICIPANT, GIVE BE A 9TH WONDER FOUNDATION PERMISSION TO USE THE ABOVE NAME PARTICIPANT’S PICTURE AND OR VIDEO ON WEBSITES (SUCH AS FACEBOOK, INSTAGRAM OR OTHER SOCIAL MEDIA ENTITIES) TAKEN DURING TRAINING SESSIONS,CAMPS OR WORKOUTS FOR PROMOTION PURPOSES ONLY.
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CHECK HERE IF YOU AGREE
For grant purposes, please indicate your household income
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Below 30,000 annually
31,000-50,000 annually
Above 51,000 annually
Please read and agree COVID-19 Safety Acknowledgement And Liability Waiver https://ninthwonder.org/covid-19-safety-acknowledgement-and-liability-waiver/
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A copy of your responses will be emailed to the address that you provided.
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