City of Shepherdsville Basketball Registration Form and Liability Waiver Agreement
Terms and Conditions
  1. I attest that I am the parent/guardian of the named player and do hereby give my permission for my child to participate in the City of Shepherdsville Fall Basketball League (hereinafter "League"). 
  2. I agree to provide transportation for my child to and from the League practices and games.
  3. I agree that I will remain on the premises for the entire duration of the League practices and games and understand the coaches, volunteers, organizers, and/or any other individual or entity involved in the League is not responsible for the care of my child during the League practices and games. 
  4. I acknowledge and understand that the City of Shepherdsville does not carry insurance on behalf of myself and/or my child.
WAIVER
In consideration for my child being permitted to participate in the League practices and games, I, the parent/guardian of the named player, on behalf of myself, my spouse, my children (including but not limited to, the named player), my parents, heirs, assigns, personal representative, and estate do hereby agree to and RELEASE AND HOLD HARMLESS the City of Shepherdsville, their employees, agents, officers, officials, affiliates, volunteers, participants (hereinafter "the City") and any and all other persons or entities acting in any capacity on its behalf as follows:
  1. I understand that participation in the League may result in serious injury, damage to my child, and/or damage to property, including but not limited to, muscle cramps, ankle, knee, and wrist injury (including sprains), dislocation of joints, cuts, abrasions, bruises, and contusions, head and/or neck injury (including paralysis), broken nose, finger, bones, etc, and that such risks cannot be eliminated without jeopardizing the essential qualities of the League.
  2. I expressly agree and promise to accept and assume all of the risks involved in my child's participation in the League. My child's participation in the League is completely voluntary, and I elect for my child to participate in the League in spite of this risk.
  3. I herby voluntarily release, waive, discharge, and agree to indemnify and hold harmless the City from any and all claims, demands, actions, or causes of action which I, and/or my child may sustain while on the premises or in any way connected to my child's participation in the League, including but not limited to, any such claims, demands, actions, or causes of action which allege negligence, negligent acts, and/or negligent omissions on the part of the City.
  4. Should the City, or anyone acting on behalf of the City, be required to incur attorney's fees and/or costs to enforce this agreement, including but not limited to, responding to any claim which I have waived or from which I have released the City hereunder, I agree to indemnify and hole harmless the City for all such fees and costs.
  5. I agree that this Agreement and any claim arising out of or relating to my child's participation in the League shall be construed in accordance with the laws of the Commonwealth of Kentucky, without regard to the conflict of laws rules. The courts of Bullitt County, Kentucky shall be the forum for any lawsuit arising out of my child's participation in the League.
  6. I agree that the terms of this Agreement are severable, such that is any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
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PLAYER INFORMATION
Player First Name *
Player Last Name
Birthdate *
MM
/
DD
/
YYYY
Gender *
Address (Include city, state, and zip) *
Phone Number *
Email *
PARENT/GUARDIAN INFORMATION
Name *
Phone Number *
Email  *
Address (include City, State and Zip Code) *
EMERGENCY CONTACT
Name of Contact *
Phone Number *
Relationship to Player *
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