Red Raider Basketball Camp Registration Form
June 26th - 29th 2023 9am to 2pm Camp Cost $225
North Rockland High School Annex Gym
Boys Grades K thru 8th
Please Venmo Payment to @northrocklandbasketball
Or Check Payable to North Rockland Basketball
Checks Can Be Mailed to
North Rockland High School c/o Jamie Ryan 106 Hammond Rd Thiells NY 10984
Campers Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grade in September
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K
1st
2nd
3rd
4th
5th
6th
7th
8th
School in September
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Thiells
West Haverstraw
Stony Point
Willow Grove
Haverstraw
Farley
St Gregs
Fieldstone
T Shirt Size
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Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Parent Name
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Cell Number
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Email Address
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Any Food Allergies or Other Concerns to Share
I am aware of the nature of this activity and I hereby assume responsibility for my son or daughter to participate and I will not hold the North Rockland Central School District/North Rockland Boys Basketball Program and/or its employees responsible in the case of accident or injury as a result of this participation. I understand that this completed form must be in the possession of the North Rockland Boys Basketball Camp prior to participation in this program. Please initial below.... COVID Waiver, Release and Indemnification:The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. North Rockland Basketball (“the Organizers”) have put in place preventative measures to reduce the spread of COVID-19; however, the Organizers cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the Organizers could increase your risk and your child(ren)’s risk of contracting COVID-19 as the facility and/or courts are open to use by others that also may have been exposed to COVID-19. By agreeing to take part in activities facilitated by North Rockland Basketball (“the Organizers”), I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Organizers’ events and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Organizers’ events may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Organizers’ employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the Organizers’ events (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, Indemnify and hold harmless the Organizers, their owners, employees, contractors, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Organizers, their employees, contractors, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Organizers’ events or facility. No oral communication may change, alter or affect the validity of this Waiver and Indemnification agreement. **NOTE: By REGISTERING and/or PARTICIPATING in any and all activities in Red Raiders Camp you are hereby accepting the terms laid out in the COVID-19 WAIVER.**Furthermore, I assume the risk of physical injury, illness, or death and agree that my child's participation shall at all times be at their own risk. I, ON BEHALF OF MYSELF AND MY PERSONAL REPRESENTATIVES, EXECUTORS, HEIRS, FAMILY MEMBERS, SUCCESSORS AND ASSIGNS, HEREBY KNOWINGLY AND VOLUNTARILY AGREE TO WAIVE, RELEASE AND DISCHARGE AND COVENANT NOT TO SUE NRCSD or NR Basketball and all of its Representatives from any liability, loss, cost, damage, expense, claim or suit whatsoever for any and all injury, loss, illness, death, harm, cost, expense, claim, suit, or damage related to my Participation, including related to COVID-19, including any negligent acts or conduct by NR Basketball and its Representatives (collectively “Claims”). I further agree to indemnify and hold harmless NRCSD and its Representatives from and against any and all third party Claims associated with my Participation. 7. I hereby grant to NR Basketball and its Representatives the irrevocable and unrestricted right to use and publish photographs and/or videos of me during Participation for advertising and/or any other purpose and to alter and copyright the same without restriction. 8. This Waiver is intended to be as broad and inclusive as permitted by the laws of the State of New York. If any portion hereof is held invalid, the balance of this Waiver shall, notwithstanding removal of such invalid portion, remain in full legal force and effect.
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