KTBL open gym waiver
*Please print form & bring to Gym*

KTBL Open Gym Waiver

Kingwood Township Basketball League

Po Box 172, Baptistown, NJ 08803

Medical Release

I understand that Basketball is a contact sport and that my child may be injured.  I assume that risk and want my child to play.  In case of a medical emergency, I authorize the coaches and league officials to seek emergency medical treatment for my child and authorize the emergency personnel and/or the attending physicians to treat my child.

Waiver & Release

I give my permission for my child to play in practices, games, and other activities sanctioned by the Kingwood Township Basketball League. I certify that he/she is physically fit to participate in the sport of Basketball and that my child has no physical problems that would inhibit him or her from vigorous physical activity. I understand that I am responsible for transporting my child to and from practices, games, and other league activities.  I the undersigned individually and/or acting through his/her parents or legal guardian on his\her behalf in consideration of acceptance into the Kingwood Township Basketball League and participation therein agree to waive any right, legal or equitable, to claim damages for any loss to persons or property occasioned by participation in such programs and further agree not to hold the Kingwood Township Basketball League, it’s officers, coaches, agents, servants, employees, or sponsors liable in any way, measure or form for the payments of such damages, and hereby release the said persons from liability on account of any injury to persons or property.  I understand that no part of the registration fee will be refunded.

Health Concerns: _____________________________________________________________

Player Name:

_____________________________________________________________

Parent / Legal Guardian Signature: ______________________________________________

Emergency Contact:                                                     Phone#:                                        Date: __________________

**All information Must be signed. No Form Will be Accepted unless signed by a Parent or Guardian**