Please complete this release of liabilty form to complete in the NGBA tournament
UPDATED TERMS OF MEMBERSHIP. By completing this release you agree to the terms of the updated terms of membership
Well, thank you for filling out the form. It seems you just wasted your time. Have a good day.
The National Gay Basketball Association strong suggest each player have an annual physical exam to ensure that your health will allow you to participate in the sport of basketball safely.
If you have not seen your doctor recently, we encourage you to do so ASAP.
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Medical Release and Authorization
As the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.
Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact my emergency contact in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach my emergency contact.
Permission is also granted to the National Gay Basketball Association and its affiliates including Directors, trainers, medical professional to provide the needed emergency treatment prior to the players admission to the medical facility.
Release authorized on the dates and/or duration of the registered tournament.
This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named player.
Informed Consent and Acknowledgement
RELEASE OF LIABILITY FORM PARTICIPANTS AND VISITORS In consideration of being allowed to participate in any way in the National Gay Basketball Associations, MAMBA SPORTS ACADEMY, events, and activities, the undersigned acknowledges, appreciates, and agrees 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 National Gay Basketball Associations, MAMBA SPORTS ACADEMY, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of MAMBA SPORTS ACADEMY, 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.
5) I do agree that“ Any and all commercial use or distribution of any visual (photography and video) footage from this private event is strictly prohibited without the expressed written consent from the National Gay Basketball Association.
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.