JR Ref Clinic Waiver (version 2)
This waiver and release of liability form is intended to inform participants and their guardians of the potential risks associated with youth basketball activities, practices, and tournaments hosted by 127 SPORTS Intensity. Please read each section carefully and sign at the bottom to acknowledge and accept the terms outlined below.
1. Heads Up Concussion Waiver
In compliance with the Heads Up Concussion initiative, I acknowledge that I have received, read, and understand the signs and symptoms of concussions. I am aware of the importance of notifying coaches and staff if a concussion is suspected during any practice, game, or activity. I agree to follow the recommended protocols in the event of a suspected concussion, including removing the participant from play and seeking medical evaluation. I understand that only a licensed healthcare professional can authorize the return to activity following a concussion.
2. Injury and Liability Waiver
I understand and acknowledge that participation in youth basketball activities carries inherent risks of injury, including, but not limited to, sprains, fractures, dislocations, and head injuries. I hereby release, discharge, and hold harmless 127 SPORTS Intensity, its coaches, volunteers, and affiliated parties from any claims, demands, or liabilities arising from injuries sustained during any club-sponsored activities. This release covers all injuries or damages, whether they are physical, emotional, or mental, and whether resulting from negligence or other causes.
3. Athlete Insurance Requirement
I understand that participation in 127 SPORTS Intensity activities requires personal health insurance coverage for each participant. I affirm that my child/ward is covered by a valid health insurance policy, and I assume full financial responsibility for any medical treatment required as a result of participation in club activities. I acknowledge that 127 SPORTS Intensity does not provide personal health or accident insurance for participants.
4. Video, Photography, and Publication Waiver
I grant permission to 127 SPORTS Intensity to capture my child/ward’s image, voice, and likeness through video, photography, or audio recordings during practices, games, tournaments, and other related activities. I understand these images and recordings may be used for promotional purposes, including but not limited to social media, club websites, printed materials, and media publications. I agree that I will not receive any compensation for the use of such media and waive any right to inspect or approve the materials where my child/ward’s likeness appears.
5. Medical Authorization and Emergency Contact
In the event of an emergency, if I am not immediately available, I authorize 127 SPORTS Intensity staff to secure medical treatment for my child/ward. I understand that this may involve contacting emergency services or transporting my child to a medical facility. I assume financial responsibility for any costs incurred as a result of emergency medical treatment.
6. Code of Conduct Agreement
I acknowledge that both my child/ward and I are expected to abide by the 127 SPORTS Intensity Code of Conduct, which promotes sportsmanship, respect for coaches, officials, teammates, and opponents, and adherence to club rules. I understand that failure to comply may result in disciplinary action, including suspension from activities.
7. Transportation Waiver
I understand that my child/ward may need transportation to and from games, tournaments, and other activities. I assume all risks associated with transportation provided by 127 SPORTS Intensity staff, volunteers, or other parents and guardians. I release the club from liability for any incident or injury occurring during transportation.
Summary and Consent
By signing below, I confirm that I have read, understood, and agreed to each waiver section above. I recognize and accept the risks involved in youth basketball activities with 127 SPORTS Intensity. I hereby provide consent for my child/ward to participate in all club activities and agree to the terms outlined above.
Acknowledgment of Entire Agreement
I certify that I have read this waiver, understand its content, and agree to all terms as stated. I understand that this waiver represents the entire agreement between myself and 127 SPORTS Intensity, and no other verbal or written statements will alter its terms.
