You can always press Enter⏎ to continue
Level Up Hoops Academy Athlete Waiver
7
Questions
START
1
Athlete's Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Birth Date
*
This field is required.
-
Month
Day
Year
Previous
Next
Submit
Press
Enter
3
Parent/Guardian Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
4
Emergency Contact's Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
5
Emergency Contact Number
*
This field is required.
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
6
Any Health Related Issues?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
7
Level Up Hoops Academy Release & Waiver of Liability & Indemnity Agreement
*
This field is required.
EACH PARTICIPANT MUST COMPLETE
In consideration of being permitted to participate in Level Up Hoops Academy activates planned and directed by Andy Saharan including the training, use of various facilities or equipment and or participation in any way in the various basketball clinics, conditioning, games and all related activities the participant for himself or herself and any personal representatives hereby agrees to the following:The participant hereby releases, waives, discharges and agrees not to sue Level Up Hoops Academy its staff, board, or members. Herein and after referred to as released parties from any and all liability to the undersigned for any loss of damage and any claims or demands therefore on account of injury to the person or property.The participant hereby agrees to indemnify and save and hold harmless the released parties and each of them for any loss, liability, damage, injury, sickness or cost they may incur due to the participation of the participant in the above basketball training activities directed by Andy Saharan or at Level Up Hoops Academy Basketball facilities in person or online. The participant hereby assumes full responsibility for risk of bodily injury, death, or property damage while participating in the above basketball training activities directed and or conducted by Andy Saharan or Level Up Hoops Academy facilities in person or online.The participant is aware that the participation in athletic activities presents a risk of physical harm or illness while participating in the above basketball training activities directed and or conducted by Andy Saharan or Level Up Hoops Academy facilities in person or online.I understand by signing this document I am waiving legal rights I may have against Andy Saharan & the Level Up Hoops Academy basketball staff, members, affiliates or representatives in reference to participating in activities despite injury, illness or death. I will follow all policies directed by Level Up Hoops Academy that are put in place for my safety to minimize contraction of diseases or risk of injury.
I hereby affirm that I have carefully read the Level Up Hoops Academy Release & Waiver of Liability document and understand its contents. I’m aware this document is a release of all liability and a contract enforceable against me in a court of law. I’ve signed this document of my own free will.
Clear
Sign With Finger ( Digital Signature Required )
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
7
See All
Go Back
Submit