Clinic Info *

Time: 8:30am-12:30pm

Week 1 (June 16-20)

Week 2 (July 21-25)

Both Week 1 & Week 2

Child Name *

First Name

Last Name

Primary Contact *

First Name

Last Name

Phone *

(###)

###

####

Secondary Contact *

First Name

Last Name

Phone *

(###)

###

####

Photo/Video Consent

I give permission to any Hoops Academy staff and trainers to use photograph(s) and/or video recording(s) of the player without any restriction to the use or publication on the Hoops Academy website and/or social media properties.

Yes

No

Waiver Form

I, hereby acknowledge that my child/children is voluntarily participating in basketball training sessions provided by Hoops Academy. I understand that basketball training involves physical activity and poses risks of injury. In consideration of being permitted to participate in the basketball training sessions, I hereby release, waive, and discharge Hoops Academy, its owners, trainers, employees, agents, and affiliates from any and all liability for injuries or damages that may arise from my participation in the training sessions. I understand that I am solely responsible for any injuries my child/children may sustain during the training sessions and that Hoops Academy is not liable for any medical expenses or damages resulting from such injuries. I certify that my child/children is physically fit to participate in the basketball training sessions and that he/she has no known medical conditions that would prevent participation. My child/children agree to follow all instructions provided by the trainers and to use the equipment and facilities provided by Hoops Academy in a safe manner. I understand that this waiver and release of liability is binding upon me and my heirs, assigns, and legal representatives.

Yes