General Liability, COVID, and Photo Release Form
Please read this form carefully and be aware that in signing, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your child might sustain as a result of participating in any and all activities connected with and associated with Atlas Hoops (Atlas Hoops, LLC).

By signing below I consent that I have read and fully understand, and agree to the above important information, warning of risk, assumption of risk and waiver and release of all claims.
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Email *
ATHLETE'S FULL NAME:
*
PURPOSE OF VISIT:  *
DATE OF BIRTH:

(Month/Day/Year)
*
PHONE NUMBER
(xxx) xxx-xxxx
*
INJURY, MEDICAL CONSENT, COVID, AND PHOTO RELEASE FORM

INJURY WAIVER: 

1. I further agree to waive and relinquish all claims I may have as a result of myself or my child participating in this program/activity against Atlas Hoops, LLC, including its officials, agents, volunteers and employees (Julian Penaranda). I do hereby fully release and forever discharge the Atlas Hoops, LLC from any and all claims for injuries, damages, or loss that I or my child may have or which may accrue to me or my child, connected with, or in any way associated with this business/program/activity.

2. I recognize and acknowledge that there are certain risks of physical injury to myself and participants in this program/activity/court, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that myself or my child may sustain as a result of said participation.

MEDICAL TREATMENT CONSENT:

I authorize ATLAS Hoop's staff to contact necessary medical authorities and administer medical treatment in case of injury during basketball activities. While efforts will be made to contact emergency contacts, immediate attention may be required. I accept responsibility for any resulting medical expenses.

COVID-19 RELEASE: 

1. I hereby forever release and waive my right to bring suit against ATLAS Hoops' and its owners (Julian Penaranda), officers, directors, managers, officials, trustees, agents, employees, subcontractors, trainers, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Atlas Hoops' services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

2. I hereby forever release and waive my right to bring suit against ATLAS Hoops' and its owners (Julian Penaranda), officers, directors, managers, officials, trustees, agents, employees, subcontractors, trainers, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Atlas Hoops' services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

3. I hereby forever release and waive my right to bring suit against ATLAS Hoops' and its owners (Julian Penaranda), officers, directors, managers, officials, trustees, agents, employees, subcontractors, trainers, or other representatives in connection with exposure, infection, and/or spread of COVID-19 related to utilizing Atlas Hoops' services and premises. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.

4. Atlas Hoops cannot prevent you [or your child(ren)] from becoming exposed to, contracting, or spreading COVID-19 while utilizing ATLAS Hoops' services or premises. It is not possible to prevent against the presence of the disease. Therefore, if you choose to utilize Atlas Hoops’ services and/or enter onto Atlas Hoops' premises you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19.

5. 
I have read and understood the above warning concerning COVID-19. I hereby choose to accept the risk of contracting COVID-19 for myself and/or my children in order to utilize Atlas Hoops' services and enter Atlas Hoops' premises. These services are of such value to me [and/or to my children,] that I accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to utilize ATLAS Hoops' services and premises in person [if applicable: “rather than arranging for an alternative method of enjoying the same services virtually (e.g. videoconference)].

VIDEO, PHOTOGRAPHY, & SOCIAL MEDIA RELEASE:

1. 
The athlete, parent or legal guardian, hereby authorizes Dr. Julian Penaranda, owner of ATLAS Hoops, to publish the videos and photographs taken of me and/or the undersigned minor children, and our names, for use on Instagram (@atlashoops_702, @dr_julianpenaranda, @peachyking, @hoopfanatictyler, and @velvports) and other social media sites.

2. 
I release Atlas Hoops, Dr. Julian Penaranda, HoopFanatic Media, Peachy King, and Velv Sports from any expectation of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the child(ren) listed below and that I have the authority to authorize ATLAS Hoops, LLC to use their photographs.

3. I acknowledge that since participation in publications and websites produced by ATLAS Hoops is voluntary, neither the minor children, nor I, will receive financial compensation.

4. I further agree that participation in any publication and website produced by ATLAS Hoops confers no rights of ownership whatsoever.

COMMUNICATION (VIA TEXT MESSAGING)

1. I consent that I have read and fully understand, and agree to allow ATLAS Hoops to utilize text messages ONLY for RENTAL, RESERVATION, AND APPOINTMENT CONFIRMATION (Message & data rates may apply.)

SEVERABILITY CLAUSE:

1. If any provision of this waiver is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. The invalidity of any part of this waiver shall not affect the validity or enforceability of any other part.
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Required
INSTAGRAM USERNAME (for ATLAS Open Runs)

If you would like VIDEOS from ATLAS Open Runs, please leave your Instagram User Name below.
EMERGENCY CONTACT INFORMATION

(First, Last Name and Phone Number)
*
By typing your name below, I acknowledge that I have read, understood, and agree to the above terms, including the risk warnings and release of claims.
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