JJC BASKETBALL ACADEMY, INC
REGISTRATION FORM
Name: Address:
City: State: Zip: EMail:
Home Phone: Other Phone:
Grade: Shirt Size: School:
3 on 3 Team Name/Comments:
Payment Information: To register make your check payable to: JJC Basketball Academy, INC.
Complete this form and send payment to: JJC Basketball Academy, INC
c/o Eileen Copenhaver
17455 Westbrook Drive
Orland Park, IL 60467
Enrollment Agreement & Release
In consideration to my enrollment and participation in JJC Basketball Academy (hereinafter referred to as JJC) programs, I hereby release and discharge JJC, together with their agents, employees, officers, owners, volunteers, and all other participants forward on behalf of myself, my children, my parents, my heirs, and assigns as follows:
1. I acknowledge that the sport of basketball involves known and unknown risks which could result in physical or emotional injury, paralysis, death, or damage to participants, to myself, to property, or to third parties, and that such risks simply cannot be eliminated. To that end, I further acknowledge that JJC is not responsible for a participant's fitness, abilities, or the equipment being used.
2. I acknowledge and agree to accept and assume any and all of the risks attendant to this activity. My child's participation in this activity is purely voluntary and I elect to participate not withstanding the risks.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless JJC from any and all claims, demands, or causes of action which are in any way connected with my child*s participation in this activity or my use of JJC equipment or facilities whether "on" or "off" the court, including any claims which allege negligent acts or omissions on the part of JJC.
4. In the event JJC, or anyone acting on their behalf, is required to incur attorney's fees and costs to enforce this agreement, I agree to indemnify and hold harmless for all such fees and costs.
5. I certify that my child has adequate insurance coverage for any injury or damage I may cause or suffer while participating, and I agree to bear any and all costs of such injury or damage. I further certify that my child has no medical or physical conditions which could interfere with my safety in this activity, and I am willing to assume all risks and costs that may result, directly or indirectly, from any such condition.
By signing this document, I acknowledge that if anyone is hurt or property is damaged during my child's participation in this activity, I have waived my rights to maintain a lawsuit against JJC.
I have had sufficient opportunity to read this entire document. I understand it and I agree to be bound by its terms.
Participant's Name Parent's Typed Release
Date
