REGISTRATION FORM Team Foundations BALLER’S DETAILS: First Name Age Last Name Date of Birth Preferred Name Gender Male Female PARENT OR GUARDIAN’S DETAILS: First Name Relationship Last Name Contact number Email BALLER’S MEDICAL BACKGROUND: (Confidential) Health condition or previous injury: (if relevant) First aid or safety strategies: How can we help encourage full participation? Consent to take Photos & Videos, Waiver of Liability and Declaration of Parent or Guardian: I give Ballers Haven Basketball Club Inc. permission to take photographs and/or videos of my child (baller) and the right to use them in their printed materials such as but not limited to banners & flyers, and online publicity such as but not limited to their website & social media accounts. I hereby understand and acknowledge that the training, games and events held by Ballers Haven Basketball Club Inc. may expose my child (baller) to many inherent risks, including accidents, injury and illness. I agree, for myself and anyone entitled to act on my behalf to hold harmless, waive and release Ballers Haven Basketball Club Inc., its coaches, employees, volunteers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my child’s (baller) participation in training, games and events held by Ballers Haven Basketball Club Inc. and I voluntarily agree to these terms. I hereby declare that the information I provided are true and correct. By checking this box, I confirm that I have read, understood, and agree to the above Consent, Waiver, and Declaration. Next
