Athlete Training - Monthly Membership Registration Form

PRICING
• Monthly membership (6 sessions): $360/month
• Sessions must be used within the month - No Refunds
• No walk-ins without registration approval

SESSION RULES
• All athletes must be registered before participating
• Group sizes are capped
• Attendance tracked every session

Name of Child

First NameLast Name

Date of Birth

Date

Age

Grade

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Select Session Time(s) (1 Hour per session)

Select Session Day(s)

Select option below

Monthly Membership

6 Sessions per month

$360.00 CAD for each month

Enter coupon

Email

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Additional Notes if applicable

Waiver: I acknowledge, appreciate, and agree that: 1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Releasees, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. MEDIA RELEASE: I agree and give consent for the King Nation Basketball organization and/or partners to record, film, photograph, audiotape or videotape my child's name, image, and performance and consent to use for advertising, promotional or commercial purposes of any kind at the sole discretion of King Nation Basketball including, but not limited to, the King Nation Basketball website and all social media platforms. 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, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.*

Signature

Date

Athlete Training - Monthly Membership Registration Form

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