click here to print this form

GIRLS' OVER THE MOUNTAIN BASKETBALL
PARENTAL WAIVER, CONSENT & RELEASE FORM
As the parent and/or legal guardian of the minor child named below, and in consideration of the minor child being permitted to participate in the Girls' Over the Mountain Basketball League, I acknowledge, agree and represent that I understand the nature of the athletic activity ("Activity") in which the minor child will be participating and the minor child's experience and capabilities and believe the minor child to be qualified, in good health, and in proper physical condition to participate in such Activity. I hereby give my full consent and approval for the minor child to participate in such Activity.

I further understand that: (a) ATHLETIC ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by the minor's own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE RELEASEES NAMED BELOW; (c) there may be OTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time, and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES the minor child may incur as a result of the minor's participation in the Activity.

I hereby RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS Girls' Over the Mountain Basketball, as well as its officers, directors, agents, employees and assigns, and the Girls' Over the Mountain basketball teams, coaches, officials, administrators, members, volunteers, participants, sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place (each considered one of the "RELEASEES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, CAUSES OF ACTION, LOSSES, OR DAMAGES ON THE MONOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

PRINTED NAME OF PARTICIPANT: ___________________________________________________

Participant's Date of Birth: ________________ Participant's Team Name: ______________________

PRINTED NAME OF PARENT/GUARDIAN: ______________________________________________

ADDRESS: ______________________________________________________________________
                            (Street)                         (City)                         (State)              (Zip)   

PHONE: _________________________________ DATE: _________________________________

PARENT/GUARDIAN SIGNATURE: ___________________________________________________


click here to print this form