Factory Basketball Summer Programs Registration Form

Request for permission: I, the above referenced youth athlete’s parent/guardian, hereby register my child to participate in Factory Basketball activities.

Assumption of risk: I acknowledge and understand that there is a risk of injury involved in athletic participation. I understand that my child will be under the supervision and direction of a volunteer or coach. I agree to follow the rules for the sport and the instructions of the coach in order to reduce the risk of injury to my child and other athletes. However, I acknowledge and understand that neither the volunteer coach nor the organization can eliminate the risk of injury in sports. Injuries may and do occur. Sports injuries can be severe and in some cases may result in permanent disability or even death. I freely, knowingly and willfully accept and assume the risk of injury that might occur from my child’s participation.

Release: In consideration of allowing my child to participate in the above basketball program, I hereby agree to release, waive, discharge, covenant not to sue, hold harmless, and indemnify, on behalf of myself and any other parent or guardian of my child, The Factory Basketball Academy and their respective volunteer youth coaches, officials, agents, employees, directors, members, officers and other staff members from liability to us and our child as well as our personal representatives, assigns, heirs and next of kin, for any and all claims, suits or causes of action arising from or out of any injury, known or unknown, to property or body that my child may suffer from participation in athletics, activities, or the above-described sports activities.

Photographs: Photographs will occasionally be taken of the children during the sports activities. By signing this registration form, I consent to the use of pictures of my child for displays, brochures and promotion materials with no compensation to me or my child.

Medical: I, the undersigned, hereby certify that to the best of my knowledge, my child is physically able to safely participate in the sports activity for which he or she has been registered. In addition, I understand that in the case of the illness or injury of my child officials from The Factory Basketball Academy will try to notify me or the emergency contact listed on this form. In the event of medical emergency concerning my child at a time when either I or the emergency contact person cannot be notified, I hereby authorize officials or my child’s coach to obtain the necessary medical care and/or treatment for my child, including but not limited to first aid, X-ray examinations, and medical or hospital care and I hereby accept the sole financial responsibility for such medical care, first aid or treatment.