KOCO

BASKETBALL WAIVER AND RELEASE OF LIABILITY FORM (For Participants Under 18)
Event/Program Name:3v3 Basketball Tournament
Date(s): 07/2/2025
Location: Mandrake Park
PARTICIPANT INFORMATION:
Name of Participant: __________________________________________
Date of Birth: ____ / ____ / ______
Age: ______
Address: __________________________________________
Emergency Contact Name: __________________________________________
Emergency Contact Phone: __________________________________________

RELEASE OF LIABILITY AND ASSUMPTION OF RISK
I, the undersigned parent/legal guardian of the above-named minor (“Participant”), acknowledge and understand that participation in basketball activities involves inherent risks, including but not limited to:
Collisions with other players
Falls, slips, or trips on court surfaces
Injuries caused by improper use of equipment
Heat-related illnesses or dehydration
Muscle strains, sprains, fractures, or concussions
In consideration of allowing the minor to participate in the above basketball activities, I agree to the following:
Assumption of Risk: I understand the nature of basketball and certify that the minor is in good health and physically fit to participate. I voluntarily assume all risks associated with participation.
Release and Waiver: I, on behalf of myself and the minor, hereby release and hold harmless the event organizers, coaches, volunteers, facility owners, sponsors, and affiliated organizations from any and all liability, claims, demands, losses, or damages arising out of or related to any injury or illness, including death, that may occur while participating.
Medical Treatment: I authorize any licensed medical professional or emergency personnel to administer any necessary treatment in case of injury or emergency. I understand I am responsible for any resulting medical expenses.
Behavioral Expectations: I understand that proper behavior and sportsmanship are expected. Disruptive or unsafe conduct may result in dismissal from the activity without refund.
Photo/Video Release (Optional): ☐ I give / ☐ I do NOT give permission for photos/videos of the minor to be used for promotional or educational purposes.

SIGNATURES
Parent/Guardian Name (Print): __________________________________________
Parent/Guardian Signature: __________________________________________
Date: ____ / ____ / ______
Participant Signature (if capable): __________________________________________
Date: ____ / ____ / ______