North Hunterdon Lions Basketball Club

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2019-20 Winter Season Player Registration

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Birthdate:

* Gender:

* Grade:

* School Attending:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Home Phone:

* Cell Phone:

Work Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Cell Phone:

Work Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

* Policy #:

* Child's medical conditions/allergies and/or restrictions::

WAIVER INFORMATION

NORTH HUNTERDON LIONS BASKETBALL CLUB MEMBERSHIP AGREEMENT

In consideration of my membership in North Hunterdon Lions Basketball Club and my participation in the Amateur Athletic Union (AAU), recognized or sponsored events ("Covered Events), I agree to the following:

I/we agree with the above *

WAIVER AND RELEASE: I am fully aware of and appreciate the risks, including the risks of catastrophic injury, paralysis and even death, as well as other damages and losses, associated with participation in a basketball event. I agree on behalf of myself, my heirs, and personal representatives, that North Hunterdon Lions Basketball Club, the host organization and the sponsor or sponsors with respect to a Covered Event, together with coaches, officials, volunteers, employees, agents, officers and directors of the host organization and any such sponsors shall not be held liable for any injury, loss of life or other loss or damage as a result of my participation in a Covered Event. This Waiver & Release shall also be for the benefit of and run in favor of any youth organization that requires participants to become members of North Hunterdon Lions Basketball Club as a condition to their participation in such organization's youth basketball events, which shall constitute Covered Events for purposes of this Waiver & Release, and any such youth basketball league shall constitute the host organization for such Covered Events.

I/we agree with the above ! *

MEDICAL ATTENTION: I hereby give my consent to North Hunterdon Lions Basketball Club and the host organization of and Covered Events to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted in the course of my participation in Covered Events.

I/we agree with the above ! *

READINESS TO COMPETE: I/my child will only participate in those Covered Events for which I believe I/she is physically and psychologically prepared to compete.

I/we agree with the above ! *

INFORMATION CERTIFICATION: I certify that all information provided by me in this application, including without limitation my membership category, is true, accurate and complete and I understand that any untrue, inaccurate or incomplete statement or information will automatically invalidate my membership and all the benefits of membership in the North Hunterdon Lions Basketball Club.

I/we agree with the above ! *

CODE OF CONDUCT: I/my child agrees to adhere to all terms in the North Hunterdon Lions Basketball Club Code of Conduct. The NHLBC Code of Conduct can be viewed under the Handouts link.

I/we agree with the above *

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2019-20 Winter Season Player Registration