Clinic Waiver

You must accept, Print and sign this waiver before  attending The clinic.

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AH Basketball Clinic Waiver of Liability (2) 

Basketball Clinic Waiver of Liability

Participant’s Name:__________________________________ Grade & Age:________
T-shirt Size:___________ Parent(s) Name:__________________________
Emergency Contact Number:__________________________
Email:
Clinic/Camp Location:____________________________
I ______________________________________, as the parent and/or legal guardian of the
participant stated above, have given my daughter/son permission to participate in the Alexis
Hornbuckle’s “Champions In Training” clinic/camp and I certify that he/she is in good health and
can take part in all clinic activities. I fully understand that participation in Alexis Hornbuckle’s
Basketball Clinic/Camp may involve serious risks and danger that may result in harm, bodily
injury and death. While particular rules, equipment, and personal discipline may reduce the risk,
I acknowledge the risk of serious injury does exist.
In the event of an emergency or an injury occurs, I authorize the camp staff members to take
all proper action and use the emergency service available at the nearest hospital if
necessary. I understand my personal insurance will be used in this case.
I, for myself and on behalf of the participant hereby release and hold harmless against any
claims, damages, and expenses and any of their directors, officials,
agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers,
and, if applicable, owners and lessors of the premises used to conduct the event.
I acknowledge and agree that Alexis Hornbuckle, Best of Both Worlds Sports Training LLC,
Cannady Media Group LLC, and Coaches retains the right to use photographs and videos
taken of the event participants for publicity and advertising purposes.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT,
FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL
RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY
INDUCEMENTS.
__________________________________________________ ________/_________/________
Print Name Date
Signature :_______________________________________________