Crafted Basketball Camp Registration Form

SATELLITE CAMP WAIVER FORM

Athlete Information

Which camp are you attending?*

Terry, MTPolson, MTWinnett, MTBillings, MT

Athlete's Name*

First NameLast Name

Date of Birth*

MonthDayYear

Grade*

Grade entering next year

Gender*

MaleFemale

T-Shirt Size*

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Information

Name:*

First NameLast Name

Cell Number:*

Area CodePhone Number

E-mail:*

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.*

Is the athlete prescribed an inhaler? If yes, please explain any instructions.*

Please bring inhaler to camp each day

WAIVER and RELEASE of LIABILITY

In consideration of being allowed to participate in any way in the CRAFTED BASKETBALL SKILLS & ACADEMY athletic/sports program/camps, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

• 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,

• I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE of the releases or others, and assume full responsibility for my participation; and,

• 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,

• I, for myself and on behalf of my heirs, assigns, personal representative and next of kin, HEREBY RELEASES AND HOLDS HARMLESS THE CRAFTED BASKETBALL SKILLS & ACADEMY, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct theevent ("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.

• I give my permission for the free use of my name and/or picture and/or for use in brochures, social media, newspaper, etc., for the promotion and information purposes of the event organizers. I (and my parent/guardian) have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I (we) have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, EVEN IF ARISING FROMTHEIR NEGLIGENCE.

I understand every effort will be made to contact me in the event of an emergency requiring medical attention for my child. However, if I cannot be reached, I authorize CRAFTED BASKETBALL SKILLS & ACADEMY, their personnel and staff, to call an ambulance or transport my child to the nearest medical care facility and secure emergency medical treatment, including hospitalization, injections, anesthesia or surgery.

Confirmation

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.

E-Signature*

Type full name