Release of Liability 12Th Annual Tumwater Youth Basketball Tournament

RELEASE OF LIABILITY

28th Annual KVA Basketball Tournament-2016

Sponsored by 90TEN TRAINING ACADEMY

I agree to hold harmless and indemnify Tumwater/Black Hills HS/90TEN Training Academy and from all claims that might be filed against Tumwater Youth Basketball, Black Hills/Tumwater HS, 90TEN Training Academy, Robin Johnson, or Tumwater School District, its hired or contracted employees, instructors, officials, or agents, for any and all injuries or losses that may be suffered because of my or my children’s participation in the above activity offered by or through 90TEN and Tumwater Schools.

I consent to my child’s participation in the activity/program of Tumwater Youth Basketball, Dave Vernon, 90TEN, Robin Johnson and its employees or agents to provide emergency medical treatment for my child on my behalf. To the best of my knowledge, my child has no physical or other condition(s) which would interfere with his/her participation.

I give my permission to have my photo or the photo of my child(ren) taken during games and activities and used for publicity purposes by the league officials.

__________________ ____ ___________________

Name of Participant Age Team

_____________________________ ___________________

Signature of Parent/Legal Guardian Division

Participation will be denied for any player who fails to return this form to Robin Johnson or the gym supervisor. Liability forms should be handed, with the rest of the team forms, to Robin Johnson before the team’s first game or mailed, with the rest of the team forms, to

Robin Johnson

8108 River Dr. SE Suite 101

Olympia , WA 98501 *Duplicate this form as needed