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BIG 6 Youth Basketball Player Registration and Release Form

Participant Information
Gender
Shirt Size
Payment Method (Checks can be written to Big6Sports. To pay by card, please contact the office)
How did you hear about this program?

Consent and Liability Waiver

I HEREBY REGISTER MY CHILD FOR Youth Basketball through the BIG 6 Sports Basketball Program and authorize the staff and coaches to direct him or her in participation of activities. I know of no mental or physical problems, which may affect his or her ability to safely participate in this activity. I authorize the staff or volunteers to attend to any health problem or injury to my child that may occur while participating. I hereby release and hold harmless the BIG 6 Sports Program, volunteers, Coaches, Agents and Board of Directors, from any liability that may arise from my child's participation. I acknowledge that I am responsible for any medical expenses due to my child's illness or injury.

Media Release

I hereby authorize BIG 6 Sports to photograph me, take video footage of me, and/or make electronic sound recordings of me (herein referred to as photographic or electronic reproductions). Further, I authorize the use of any such photographic or electronic reproductions of me for any purpose, including but not limited to educational and other public media as may be deemed appropriate by BIG 6 Sports (I understand that I may be identifiable from such photographic or electronic reproduction).  I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.  I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. 

Thanks for your registration!

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