Basketball League Waiver

Added by LaJuan Smith


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LaJuan’s Hoop League WAIVER FORM
(Must be completed and turned in prior to your child/children’s participation).
Parent or Guardian Release:

Player Name (s)-_______________________________________________

Email Contact-_________________________________________________

*** Emergency Contact Numbers**-_____________________________________________________________

By enrolling my player, I ensure that such individual is physically and mentally able to participate in “LaJuan’s Hoop League” has been examined by a licensed medical physician within one (1) year prior to attending these basketball sessions. I understand that LaJuan Smith and Timmy Hayes, Boys and Girls Club of Glasgow-Barren County or employees, representatives, independent contractors working for or in partnership with BGC, or the property where the session is held (HERO CENTER) and any or all of its officials cannot be held responsible in whole or in part for any accidents, illness or injuries resulting in medical or dental expenses incurred from participation in this program. I hereby release each of them from and against any and all claims, costs, liabilities and injuries incurred while in session.
I agree to assume full and complete responsibility for any and all medical bills arising from a player's participation. In the event of any emergency, I authorize Athletic Staff to exercise its judgment in the treatment of said player by a medical authority. By signing this release and agreement I acknowledge that I have read and fully understand and agree to all of its terms.

Parent/Guardian Signature


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