Added by Cas Brown
Updated
I affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms of COVID-19, including, but not limited to, cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss
of taste or smell WITHIN THE LAST 14 DAYS. I affirm that I, as well as all household members, do not have any pending COVID-19 test results. I affirm that I, as well as all household members,
have not been diagnosed with COVID-19 WITHIN THE PAST 30 DAYS. I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19
WITHIN THE PAST 30 DAYS. I affirm that I, as well as all household members, have not traveled outside of the country, or to any city considered to be a "hot spot" for COVID-19 infections WITHIN
THE PAST 14 DAYS. I understand that PowerLine Basketball Camps can be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each player.
• By signing below, I agree to each statement above and release PowerLine Basketball, and any and all participants in this event who can be proved to be truthful on this waiver from any and all liability for the unintentional exposure or harm due to COVID- 19.
• Informed Consent and Acknowledgement
I hereby give my approval for my/my child’s participation in PowerLine Basketball Camps. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold
harmless PowerLine Basketball Camps and all its respective officers, agents, and representatives, including, but not limited to PowerLine Basketball, from any and all liability for injuries to said player arising out of travel to, participating in, or returning from this Camp.
In case of injury to said player, I hereby waive all claims against PowerLine Basketball including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct this event.
Furthermore, all images and videos of PowerLine Basketball Camp events are the property of Poweeline and can be used for any promotional consideration.
I hereby state that I have carefully read the above waiver. Acceptance and understanding of this agreement are hereby acknowledged.
I have read and agree to the Informed Consent and Acknowledgement.