Registration and Waiver Form Athlete InformationAthlete Name* First Last Athlete Date Of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920School*Grade*Parent InformationParent Name* First Last Parent Phone*Parent Email* Additional Emergency ContactRelease of liabilityIn consideration of Ball Hogg Academy training program and granting the athlete permission to participate, I hereby state that Ball Hogg Academy program and the individuals representing the Ball Hogg program are not responsible for any preexisting injury or recurrence of any undisclosed preexisting injury or illness of the listed athlete. I further acknowledge and release the Ball Hogg Academy program, all coaches, and all its participants with the program from all liability including claims and suits at law or equity for injury that may result from the athlete taking part in the Ball Hogg Academy program.Release of liability - INITIALS*Parent or legal guardian acknowledgeI, as a parent or legal guardian, acknowledge and fully understand that the participant will be engaging in activities that involve risk or serious injury and that there may be other risks not known or not reasonably foreseen at this time. I assume all the foregoing risks and accept personal responsibility for any damages following such injury, permanent disability, or death. I hereby consent to said minors participation and assume all the risks of his/her personal injury that may result from program activities. Acknowledge - INITIALS*PHOTO AND DIGITAL PHOTOGRAPH RELEASEI hereby authorize Ball Hogg Academy Basketball Administration, the right to reproduce, distribute, transmit, publish, display, in whole or in part, either digitally or in any other medium used, my child’s name and/or photographic image. I agree that such reproduction of picture/video may be edited as desired and used in whole or in part in the activities of Ball Hogg Academy. I release and discharge BallHogg Academy and its agents, representatives, and assignees from any claim or cause of action now know or later discovered, for among other things, invasion of privacy, right of publicity, and defamation arising out of the use and utilization of the photographs.Signature* This iframe contains the logic required to handle Ajax powered Gravity Forms.