Dream Chasers 
 Basketball Participation Form 
** This form must be completed by each current player and new players** 
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Participant's Name (First & Last Name)  *
Participant's Address with city and zip code  *
School Attending  *
Grade  *
Date of Birth *
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Parent(s) Name:  *
Parent(s) Cell Phone  *
Parents / Guardian(s) email:  *
Injury Liability Waiver Form / Hold Harmless Agreement:
WHEREAS, 916 Dream Chasers Basketball has been organized for the purposes of furthering the Boy’s and Girl’s Basketball Program; and
WHEREAS, the 916 Dream Chasers Basketball as one of its ventures, conducts tournaments and practices for
various age groups of children; and WHEREAS, as a consideration for providing the basketball tournaments and practices, the parents of participating child agree to indemnify and hold harmless the DC Basketball and
916 Dream Chasers and all of its members, employees, schools, representatives and successors from any and all claims, losses, damages or expenses of any kind,
including legal expenses, in the event of an accident or injury to themselves and/or their respective children.
NOW, THEREFORE, in consideration for the undertaking of 916 Dream Chasers Basketball herein stated and for other and valuable consideration, the undersigned parents of participating child hereby agree to the following terms and conditions and upon no other conditions. The undersigned
parents of participating child agree to indemnify and hold harmless 916 Dream Chasers Basketball and all of its members, employees, schools, representatives and
successors from any and all claims, losses, damages or expenses of any kind, including legal expenses, rising out of the operation of the basketball practices and tournaments in which the child participates, including, but not limited to, claims for personal injuries, death or property damage. 916 Dream Chasers and all of its members, employees or agents do not guaranty or make any representations concerning the safety, suitability or legal sufficiency of any equipment or property upon which the activity will be held, but only agrees there under to permit the child to use the aforesaid items at the location at which the activity will be conducted, and the undersigned parents of participating child accept all risks associated with the use of the equipment and facilities.
IN WITNESS WHEREOF, 916 Dream Chasers basketball, the parent or legal Guardian of the above-named participating child, has signed this Injury Liability Waiver
Form / Hold Harmless Agreement. 
** Print your first and last name and date, below**
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