Basketball Participation Form 2018
Participant's Name:______
Grade: 5th 6th 7th 8th 9th 10th 11th
Injury Liability Waiver Form Hold Harmless Agreement
WHEREAS, the Green Bay Purple Aces Inc. has been organized as a nonprofit partnership of various individuals in the Green Bay area; and
WHEREAS, the Green Bay Purple Aces Inc., as one of its not-for-profit ventures, conducts basketball skills clinics, and practices for various age groups of children; and
WHEREAS, as a consideration for providing the basketball skills clinics, and practices, the parents of participating child agree to indemnify and hold harmless the Green Bay Purple Aces, Inc.. and the representatives and successors from any and all claims, losses, damages or expenses of any kind, including legal expenses, in the event of an accident or injury to themselves and/or their respective children.
NOW, THEREFORE, in consideration for the undertaking of the Green Bay Purple Aces, Inc. herein stated and for other good and valuable consideration, the undersigned parents of participating child hereby agree to the following terms and conditions and upon no other conditions. The undersigned parents of participating child agree to indemnify and hold harmless the Green Bay Purple Aces, Inc. from any and all claims, losses, damages or expenses of any kind, including legal expenses, rising out of the operation of the basketball skills clinics, practices in which the child participates, including, but not limited to, claims for personal injuries, death or property damage. Green Bay Purple Aces, Inc. do not guarantee or make any representations concerning the safety, suitability or legal sufficiency of any equipment or property upon which the activity will be held, but only agrees there under to permit the child to use the aforesaid items at the location at which the activity will be conducted, and the undersigned parents of participating child accept all risks associated with the use of the equipment and facilities.
IN WITNESS WHEREOF, , the parent or legal guardian of the above named participating child, has signed this Injury Liability Waiver Form / Hold Harmless Agreement this day of 2018.
Print Name of Parent or Guardian:______
Parent or Legal Guardian Signature: ______
Date:______
2018 Waiver
This document must be completed accurately and signed by a parent or legal guardian of the athlete before he will be permitted to participate in Green Bay Purple Aces, Inc.
(Please Print)
Name of Athlete:______
RELEASE AND CONSENT: I assume all risks associated with playing basketball for Green Bay Purple Aces, Inc. Having read this release and knowing these facts, I hereby waive the directors, sponsors, coaches and supervisors of Green Bay Purple Aces, Inc. from all claims, liabilities or responsibilities for injuries of any kind arising from my child's participation in the Green Bay Purple Aces, Inc. program. I hereby certify that my child is in good health and is able to participate in basketball without risk to his or her health. I agree to allow my child to be treated in the event of a simple injury common to the game of basketball. I give the Green Bay Purple Aces, Inc. supervisors or coaches permission to Summon emergency medical services for my child should they judge this to be necessary.
Name of parent or legal guardian: (please print): ______
Signature of parent or legal guardian: ______
Date: ______