"TEAM ICHIBAN BASKETBALL CLUB"
Medical/Liability Release Form
I hereby authorize the staff of the Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions or Spring Spirit School to act for me, according to their best judgment, in any emergency requiring medical attention, and hereby waive and release the instructors and its teachers/directors or anyone associated with the Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions or Spring Spirit School from any liability for any injuries or illnesses incurred while at any tryout, basketball skills session or any related functions.
I have no knowledge of any medical problem or physical impairment that would be affected by participation. Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions or Spring Spirit School or the nearest medical facility is hereby authorized to render primary care.
Assumption of Risk/Release from Liability
It is further understood that Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions nor Spring Spirit School does not provide medical insurance covering injuries of any nature incurred at any Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions or Spring Spirit School. The undersigned hereby releases Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions or Spring Spirit School, its successors, assigns, officers, agents, and employees, from any and all claims, demands, and causes of action whatsoever in any way growing out of or resulting from participation in Team Ichiban Basketball Club, Gene Watts Basketball Educational Skills Sessions or Spring Spirit Schoolp functions.
Participant’s Name:____________________________________________
Participant’s Signature:_________________________________________
Participant’s Parents/Guardian’s
Signature:____________________________________________________