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Athlete Name

First Name

Last Name

Parent Name

Parent Email

Address

Phone

Country

(###)

###

####

Athlete Date of Birth

YYYY

Current TShirt Size of Athlete

Athelete Email

Gender

Current Grade

Uniform Size

Shoe Size

ASSUMPTION OF RISK, RELEASE, WAIVER, CONSENT INDEMNITY

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my myself and or my child (including, but not limited to, personal injury, disability, and death), illness, disease, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at Scott Warriors Basketball (SWBA) games, practices or activities and/or my participation in such games, practices or activities. I understand that SWBA is implementing Return to Play Guidelines (RTP Guidelines) implemented and designed by the Ontario Basketball Association. The most recent version can be found on the OBA website. I am aware of the RTP Guidelines, that the child named above and I will abide by the RTP Guidelines and the RTP Guidelines are subject to all federal, provincial, and municipal laws, regulations, bylaws, and orders as they may exist from time to time. I hereby release, covenant not to sue, discharge, and hold harmless SWBA, 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 the SWBA, its employees, agents, and representatives.

Travel Waiver

To release the Scott Warriors Basketball Association, its members, employees, coaches, players, managers and/or management, Executive Directors, or any other SWBA representatives or other organizations affiliated with the SWBA from any and all liability, loss, damage, costs, claims and/or causes of action, including but not limited to all bodily injuries and property damage arising out of participating in the event referred to above, it being specifically understood that said event includes the participation of your registered athlete with SWBA players, coaches and staff by the undersigned participant and/or legal guardian.

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, provincial / state, and local governments and federal and provincial / state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. SWBA cannot guarantee that you will not become infected with COVID-19. Further, attending practice, games and other related gatherings could increase your risk of contracting COVID-19.

Consent to Report and Disclose

SWBA is authorized to record personal information, imaging and audio recordings in any medium of the child named above or me at or in relation to any SWBA event, for publicity and promotional purposes or regarding the implementation of the RTP Guidelines. I hereby consent to the collections, use and disclosure of such personal information about me and/or the child named below.

Acknowledgement

I am the legal guardian or custodial parent of the child above below. I am or the child named above is physically fit to participate in any SWBA program or event. I acknowledge that I have read and understand this agreement, that I have executed this agreement voluntarily, and that this agreement is to be binding upon myself, my heirs, spouse, children, parents, guardians, next of kin, executors, administrators and legal or personal representatives. I further acknowledge by signing this agreement I have waived my right to commence or maintain any actionagainst the Organization on the basis of any claims from which I have released herein.

Yes

Name of Person Filing this Submission

First Name

Last Name

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