Consent/Waiver Form
NRBA INFORMED CONSENT, ASSUMPTION OF RISK, RELEASE AND WAIVER
PARTICIPANT INFORMATION
Full Legal Name(s) of Participant(s):
Date(s) of Birth of Participant(s):
Name of Person Signing This Agreement:
Please select the option that applies:
APPLICABILITY OF THIS AGREEMENT
The person signing this agreement must select one of the options above. If the signer selects that they are the parent or legal guardian of one or more participants under 18, the Minor Participant Waiver applies separately to each minor participant named in this agreement. If the signer selects that they are the participant and are 18 years of age or older, the Adult Participant Waiver applies.
For the purposes of this agreement, each person under 18 named above is individually referred to as a "Minor Participant," and all such persons are collectively referred to as the "Minor Participants."
By signing this agreement, I certify that the selection I made is accurate and that I have the authority and capacity to enter into the applicable waiver on behalf of myself or each Minor Participant named in this agreement.
MINOR PARTICIPANT(S) WAIVER
This section applies only when the signer is the parent or legal guardian of one or more participants under 18. It applies separately to each Minor Participant named in this agreement.
I am fully aware of the rules, risks and hazards connected with participating in the sports-related activities associated with North Ridge Basketball Academy ("NRBA"). I have been informed that each Minor Participant may be challenged to exert themselves in an intense manner, more so than in a typical school physical education class setting. I knowingly and voluntarily consent to each Minor Participant's participation in such potentially hazardous activities and assume the risk of any injuries, regardless of severity and including death, that any Minor Participant may incur as a result of such activities.
I verify that each Minor Participant has no physical disabilities, impairments or chemical dependencies that might inhibit their participation in sports activities; that I have major medical health insurance coverage for each Minor Participant; and that each Minor Participant has recently undergone a complete physical examination with satisfactory results suggesting no reason that they should not participate in NRBA activities.
I hereby release, discharge and waive any and all responsibility to any and all staff, volunteers, board members, hosts and any other persons or entities affiliated with NRBA against all claims of liability for any and all trauma, injury, damage, expense, handicap or disability, including death, resulting from or attributable in whole or in part to any Minor Participant's participation in NRBA activities. NRBA was not asked to exercise any judgment regarding any Minor Participant's ability or the advisability of their participation in NRBA activities.
I agree to indemnify and hold harmless NRBA, its officers, agents, staff, volunteers, representatives, related entities and hosts from and against all liability, claims, demands, actions, losses, costs, fees and damages arising out of any Minor Participant's participation in NRBA activities.
This Informed Consent and Waiver Agreement will be construed under and pursuant to the laws of the State of North Carolina.
I certify that I am at least 18 years of age, am competent to sign this consent and release, am the parent or legal guardian of each Minor Participant named in this agreement, and have read, understood and agreed to all provisions contained herein.
ADULT PARTICIPANT WAIVER
This section applies only when the signer is the participant and is 18 years of age or older.
I am fully aware of the rules, risks and hazards connected with participating in the sports-related activities associated with North Ridge Basketball Academy ("NRBA"). I have been informed that I may be challenged to exert myself in an intense manner. I knowingly and voluntarily consent to participating in such potentially hazardous activities and assume the risk of any injuries, regardless of severity and including death, that I may incur as a result of such activities.
I verify that I have no physical disabilities, impairments or chemical dependencies that might inhibit my participation in sports activities; that I have major medical health insurance coverage; and that I have recently undergone a complete physical examination with satisfactory results suggesting no reason that I should not participate in NRBA activities.
I hereby release, discharge and waive any and all responsibility to any and all staff, volunteers, board members, hosts and any other persons or entities affiliated with NRBA against all claims of liability for any and all trauma, injury, damage, expense, handicap or disability, including death, resulting from or attributable in whole or in part to my participation in NRBA activities. NRBA was not asked to exercise any judgment regarding my ability or the advisability of my participation in NRBA activities.
I agree to indemnify and hold harmless NRBA, its officers, agents, staff, volunteers, representatives, related entities and hosts from and against all liability, claims, demands, actions, losses, costs, fees and damages arising out of my participation in NRBA activities.
This Informed Consent and Waiver Agreement will be construed under and pursuant to the laws of the State of North Carolina.
I certify that I am at least 18 years of age, am competent to sign this consent and release, and have read, understood and agreed to all provisions contained herein.
PHOTO AND VIDEO RELEASE
The North Ridge Basketball Academy (NRBA) utilizes both individual and group photographs and videos from all its camps and training sessions to enhance our official website and Instagram presence. However, to ensure the safety and privacy of our youngest participants, the NRBA refrains from publishing individual photos or videos of children, age 13 and younger, without explicit parental/guardian consent. We are committed to protecting our students and their image.
If there is ever a photo or video of your child that you wish to be removed from our website or Instagram page, please contact the NRBA, and your request will be granted.
FINAL CERTIFICATION
By electronically signing below, I certify that:
- The participant and signer information provided above is accurate.
- I selected the signer capacity that applies to me.
- If signing for Minor Participants, I am the parent or legal guardian of each Minor Participant named in this agreement.
- I have read and understood the applicable waiver section.
- I agree to be bound by the applicable waiver section on behalf of myself or each Minor Participant named in this agreement.
- I have read and agreed to the photo and video release statement above.
