Spring Break Camp 23’ Registration Form

Player's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent/Guardian Phone Number

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Waiver of Liability Including COVID-19 *

Assumption of Risk and Waiver of Liability Including Liability Relating to COVID-19 In order for players to participate in following activities, players or legal guardians (if a minor) are required to read and sign the following Assumption of Risk and Liability Waiver. I understand that those who participate in activities and athletics such as: basketball training, practice, basketball games, camps and/or tournaments are physically high risk and can lead to injuries, including severe injuries such as fractures, muscle injuries, torn ligaments, tendons as well as paralysis and death. I also understand that those who participate in activities and athletics such as: basketball training, practice, basketball games, camps and/or tournaments are also at a higher risk of exposure and spread of the COVID-19 virus due to the lack of social distancing, shared equipment, and ventilation. I agree to do my part to limit the exposure to and/or transmission of COVID-19, to myself, my child, members of my household, and those around myself, my child, and household members, I agree to adhere to the recommendations of the CDC including: • Proper general hygiene (https://www.cdc.cov/healthywaterihygleneibodWindex.html) • Proper hand washing techniques (https://www.cdc.gov/handwashinq/when-how-handwashinq.html) • Proper use of personal protective equipment when required (masks, and/or eye protection) • Not sharing any personal items (towels, soap, brushes, clothes, water bottles, make-up, lip balm, etc.). I agree the player will not attend any event if symptomatic of COVID-19 and I will report any possible COVID-19 exposure or symptoms to the coaches of Pass the Rock. I hereby authorize the directors of Pass The Rock to act for me according to their best judgment in any emergency requiring medical attention. I release all personnel and employees of Pass The Rock from all liability for any injury and illness incurred while at in attendance. I have insurance covering me in case of an injury. I voluntarily agree to assume all risks and accept sole responsibility for any injury and/or illness to the player or anyone related. I hereby release, covenant not to sue, discharge, and hold harmless Pass the Rock, LLC., their officers, officials, agents, volunteers, employees, other participants, sponsoring agencies, sponsors, advertisers with respect to any and all injury, illness, disability, loss or damage to person or property, expenses, and/or death arising out of trauma event, act of negligence or relating to COVID-19. I understand this release includes any claims based on the actions, omissions, or negligence of the Releasees, and whether a COVID-19 infection occurs before, during or after my participation. The terms hereof shall serve as a release and assumption of risk for my heirs, estate, executor, administrator, assignees, and all members of my family.

By checking this box I agree to all above stated terms and conditions