Hoop Dreams &Turkey Drives - Registration & Assistance Request

Hoop Dreams &Turkey Drives - Registration & Assistance Request

By Larry Legend's DREAMS
Thank you for your interest in our FREE Youth Empowerment Basketball Clinic! Please complete this form to register your child for the clinic. The second part of the form is an optional request for a turkey and Christmas assistance, which is prioritized for clinic participants. One form per child, please.
OUR SPONSORS

First Baptist Church Denbigh, DYNOX LLC, & Relentless Sports
GUARDINS MUST BE PRESENT TO RECEIVE ASSISTANCE
Player & Guardian Information
Child's Full Name

First NameLast Name
Child's Age
Child's Date of Birth

MonthDayYear
Date
Gender
Guardian's Full Name

First NameLast Name
Guardian's Primary Phone Number
Please enter a valid phone number.
Guardian's Email Address
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Emergency Contact (other than Guardian)

First NameLast Name
Emergency Contact's Phone Number
Please enter a valid phone number.
Does the participant have any known medical conditions, allergies, or special needs we should be aware of to ensure their safety?
PLEASE READ CAREFULLY. THIS IS A LEGALDOCUMENT.

GUAIRDIANS MUST SIGN THE RELEASE OUTLINED BELOW AT THE EVENT
Activity and Associated Risks: I understand that my child’s participation in the “Hoop Dreams & Turkey Drives” Youth Empowerment Clinic, involving basketball, physical exercise, and related activities, involves inherent risks including, but not limited to, falls, collisions, strains, sprains, and other injury.

Release of Liability: In consideration for my child being allowed to participate in this event, I, the undersigned, on behalf of myself, my child, our heirs, and assigns, hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE the event sponsors and partners, including but not limited to: Larry Legend's DREAMS Inc., DYNOX LLC, Williams Education and Development Group (WEDG), First Baptist Church Denbigh, its staff, and all volunteers (hereinafter "Releasees"), from any and all liability, claims, demands, or causes of action for any injury, loss, or damage to my child or their property, whether caused by the negligence of the Releasees or otherwise, while my child is participating in the event or on the premises.

Medical Emergency Permission: I give permission for the event organizers or designated medical personnel to secure emergency medical treatment for my child in the event of injury or illness, and I accept responsibility for any associated costs.

Photo/Video Release: I grant full permission to the event organizers to use photographs, video recordings, and quotes from my child in promotional materials, social media, and news reports without compensation.

Acknowledgment of Understanding: I confirm that I am the parent or legal guardian of the child named above. I have read this waiver, fully understand its terms, and sign it freely and voluntarily.

GUARDIANS MUST BE PRESENT TO SIGN RELEASE
Turkey & Christmas Assistance Request

(OPTIONAL)
This assistance is made available through the generosity of our community partners and is prioritized for families of registered clinic participants. Completing this section does not guarantee assistance, but places you on our list for distribution.
Would your family like to be considered for a FREE turkey at our event on November22nd?

YesNo
Would your family like to be considered for Christmas assistance (e.g., toys,gifts, food) for the upcoming holiday season?

YesNo
To help us understand the need and serve you better, please indicate your family's approximate household size (number of people)
Is there any specific need or challenge your family is facing that you wouldlike to share? (Optional)
By submitting this form, I confirm that all the information provided is accurate to the best of my knowledge
First Baptist Church Denbigh (Family Life Center-Gymnasium)

3628 Campbell Road

Newport News, VA 23602

(757) 877-5808
Should be Empty:

Hoop Dreams &Turkey Drives - Registration & Assistance Request

OUR SPONSORS

PLEASE READ CAREFULLY. THIS IS A LEGALDOCUMENT.

Turkey & Christmas Assistance Request

By submitting this form, I confirm that all the information provided is accurate to the best of my knowledge