Tournament Activity Release Form

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By completing and submitting this form you agree to the Play Hard Hoops Small Group Camps/Hoops Education LLC waiver.

Participant First Name *

Participant Last Name *

Name of team your child is on *

Gender *

Male

Female

Participant Age *

Parent/Guardian 1 Name *

Parent/Guardian 1 Phone Number *

Parent/Guardian 2 Name

Parent/Guardian 2 Phone Number

Address (including city, state and zip code) *

First and Last Name of Parent/Guardian Completing this Form *

Relationship to Participant *

Play Hard Hoops Small Group Camps/Hoops Education LLC waiver (Must be completed by a parent/guardian if under the age of 18.) *

I do hereby assume full responsibility for any and all damages, injuries (including death), or losses that I may sustain orincur, if any, while attending, engaging, practicing, participating or witnessing activity and/or certain event(s) occurringin or about the premises or at any offsite location. I hereby assume full risk, waive all claims and release and hold PlayHard Hoops Small Group Camps/Hoops Education LLC, individually or otherwise, harmless for any and all liability, claims,suits, damages, communicable diseases, expenses, fees, actions, or rights of action or judgments as a result of injury ordeath to myself or members of my family or heirs, or my guests, or damage, destruction or loss to my property, which inany way relates to, arises out of, or is in any way connected with my presence on the premises, or my participation inevents of activities thereon, or the negligent acts or omissions of the releases or any other third party. I agree to wear all protective equipment required while participating in the activity, and I am fully aware and understandthat Play Hard Hoops Small Group Camps/Hoops Education LLC does not have on or about the premises, or employ orcontract with any medical services, provisions for ordinary or emergency medical services.In consideration of my participation in and the use of the Play Hard Hoops Small Group Camps/Hoops Education LLCpremises or facilities, I hereby release and covenant not to sue the owner of the premises (releases), shareholders,directors, officers, employees, representatives, agents, affiliates and lessees from any and all claims resulting from anyphysical injury that may occur to me while participating in any program or event sponsored by Play Hard Hoops SmallGroup Camps/Hoops Education LLC.Additionally, Participation includes possible exposure to and illness from infectious diseases including but not limited toMRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk ofserious illness and death does exist; and,I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISINGFROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation;

BY CHECKING THIS BOX, I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE RELEASE/WAIVER AND FULLY UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS WAIVER VOLUNTARILY.

Required

Daily Screening Form *

I certify that I have answered "No" to all the questions listed: 1) In the past 24 hours has the participant had a new or worsening cough. 2) In the past 24 hours has the participant had diarrhea or vomiting? 3) In the past 24 hours has the participant had a fever temperature greater than 100.4 for children and adults (without taking any fever reducing medication)? 4) In the past 24 hours has the participant had shortness of breath or trouble breathing? 5) In the past 24 hours has the participant had a new loss of smell and/or taste? 6) In the past 24 hours has the participant had a sore throat, different than your seasonal allergies? 7) Do you have a household member or close contract who has been diagnosed with or or has been a close contact to someone diagnosed with COVID-19 in the past 2 weeks or is awaiting results from a COVID-19 diagnostic test?

By checking this box, I agree that I have answered "No" to all the screening questions.

Required

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