BT Basketball

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Winter Teams

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

* City:

State:

Zip Code:

Home Phone:

Birthdate:

* Email:

* Gender:

* Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

* EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

WAIVER INFORMATION

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide
pandemic by the World Health Organization. COVID-19 is extremely
contagious and is believed to spread mainly from person-to-person
contact. As a result, federal, state, and local governments and federal and
state health agencies recommend social distancing and have, in many
locations, prohibited the congregation of groups of people. BT Basketball, LLC has put in place preventative measures to reduce
the spread of COVID-19, MRSA, INFLUENZA; however, we cannot
guarantee that you, your child(ren), or family members who visit our
facility will not become infected with COVID-19. Further, attending BT
Basketball could increase your risk, your child(ren)?s risk, and your
family's risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of
COVID-19 and voluntarily assume the risk that my child(ren), my family, and I may be exposed to or infected by COVID-19 by attending BT
Basketball events and that such exposure or infection may result in
personal injury, illness, permanent disability, and death. I understand that
the risk of becoming exposed to or infected by COVID-19 at BT
Basketball may result from the actions, omissions, or negligence of
myself and others, including, but not limited to, BT Basketball LLC
employees, volunteers, and program participants and their families. I VOLUNTARILY AGREE TO ASSUME ALL OF THE
FOREGOING RISKS AND ACCEPT SOLE RESPONSIBILITY FOR
ANY INJURY to my child(ren), family or myself (including, but not
limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may
experience or incur in connection with my child(ren)?s attendance at BT
Basketball or participation in BT Basketball programming (?Claims?). On my behalf, and on behalf of my children, I hereby release, covenant
not to sue, discharge, and hold harmless BT Basketball LLC, its
employees, agents, and representatives, of and from the Claims, including
all liabilities, claims, actions, damages, costs or expenses of any kind
arising out of or relating thereto. I understand and agree that this release
includes any Claims based on the actions, omissions, or negligence of BT
Basketball, LLC, its employees, agents, and representatives, whether a
COVID-19 infection occurs before, during, or after participation in any of
our programs.
BT Basketball Parent / Guardian Acceptance of
Risk & Release of Liability
By registering with BT Basketball (any type of clinic or camp or team)
you are agreeing to the following waiver. I, the parent/guardian/ participant, in registering with BT Basketball
LLC, understands that he/she/I in attending the events for BT Basketball
and using the facilities does so at his/her/my own risk. I acknowledge that I am aware of the risks inherent in participating in
basketball; both practice and competition; that basketball is a physical
sport which can require considerable running and physical exertion; and
could potentially lead to body harm or limb injuries and even death. Participants and parents assume full responsibility for all injuries and
damages which may occur in or at any of BT Basketball events. He/she/I do or does hereby fully and forever release, discharge and
hold harmless BT Basketball LLC, and any partner schools' organizers, owners, employees, sponsors, and agents from any and all claims, demands, damages, rights of action, property loss, present or future
resulting from or arising out of any person?s participation. In addition, he/she/I agree(s) to follow rules of play and conduct set
by BT Basketball and the gym site(s). He/she/I understand(s) that failure
to do so my result in suspension from participation. I give permission for my child/child's picture and video to be taken
and used in league website, advertising, materials and social media.
Name of parent/guardian: ___________________________________
Parent guardian/signature: _________________________________
Player name:________________________________________________
Date signed: _______________________________________________

I/we agree with the above *

* indicates required fields

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Winter Teams