; Optimist
Learning Center
Plans & pricing Sign in
Sign Out
Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>



  • pg 1
									 optimist club of bismarck
  youth basketball camp
      Monday February 20th• Bismarck Civic Center • 7pm Tip-Off

                               The Wizards would like to offer all parents
                               and families discounted General Admission
                               tickets for $9. Students will receive General
                               Admission tickets for $5. For every adult
                               ticket purchased using this flyer, $1 will be
                               donated to the Optimist Club of Bismarck.
                               Come on out and watch your son and/or
                               daughter be part of a NBA Development
                               League experience! For more information,
                               contact Tom Miller @ (701) 202-6046 or
                               222-1679. Hurry, the deadline is Thursday,
                               February 16th.
                               ** CAMP IS FREE AND ALL PARTICIPANTS RECEIVE A
                               FREE DAKOTA WIZARDS TICKET **

                                                    Optimist Club of Bismarck Electric Youth Camp
                                                                Monday, February 20th,2012

                                              Name ________________________________________

                                              Address _______________________________________

                                              City, State, Zip ____________________________________

                                              Phone ________________________________________

                                              Email ________________________________________

                                                 # Tix       Section                           Total
                                                             GA (adults) - $9
              vs                                             GA (students) - $5

                                                         Visa Mastercard Cash Check #___________

                                               Credit Card #        Return to:           Exp. Date
                                               Dakota Wizards • PO Box 4066 • Bismarck, ND 58502
                                                             or fax to (701) 255-7967

CALL (701) 202-6046 OR 222-1679 FOR MORE INFO
                                   Youth Basketball Clinic
                                   With the Dakota Wizards
                                 When:     Monday, February 20, 2012 - 4-5pm-Clinic
                                           5-6pm Pizza and Prizes
                                 Where: Bismarck Civic Center
                                 Who:      All Boys or Girls ages 7-12 Years Old
                                 RSVP:     Call Tom @ 202-6046 or 222-1679 to Register
                                 Deadline: Thursday, February 16th
                                 Cost:     FREE!!!- Space is limited

                       S YOUTH
        FR EE WIZARD               @ 4-5PM0, 2012
                           RY 20THON FEBRUARY 2
      M          TO WIZA
               S FREE
CLINIC INCLUDE                  CALL (701) 202-6046 OR 222-1679 OR
                                                  GENERAL RELEASE

For good and valuable consideration, receipt of which is hereby acknowledged and of the participation of the individual listed
below (the “Participant”) in Optimist Club of Bismarck Youth Basketball Camp, to be held on February 20, 2012 at 4pm
at the Bismarck Civic Center (the “Event”), I hereby give permission for the Participant, who is either me, my child or ward,
to participate in the Event. Further, I hereby:

1.   acknowledge and accept sole responsibility for all of the hazards and risks to Participant and Participant’s property
     associated with or related to Participant’s participation in the Event and for any damage or injury that Participant may
     cause to others;

2.   release, waive and forever discharge any and all claims of damages or causes of action, including but not limited to,
     death, personal injury or loss or damage to property, which I, the Participant or any of the Participant’s representatives,
     heirs, next of kin or assignees (“Participant’s Representatives”) may have or which may hereinafter accrue to me, the
     Participant or Participant’s Representatives as a result of the Participant’s participation in the Event or otherwise and
     which may be asserted by me, the Participant, or Participant’s Representatives against GSW Development LLC, NBA
     Development League, LLC, the National Basketball Association, and their respective member teams, parents,
     subsidiaries, affiliates, divisions, members, managers, directors, officers, owners, governors, officials, agents,
     respresentatives, employees, successors and assigns (collectively, the “Released Entities”), whether caused by the acts,
     omissions or negligence of the Released Entities or by any other person or entity;

3.   grant permission to the Released Entities to utilize Participant’s name, voice, statements, photograph, image, likeness,
     actions and/or biographical data in any live or recorded form (including, but not limited to, any form of video display or
     other transmission or reproduction), in whole or in part, for promotional, commercial or any other purpose, in perpetuity
     worldwide in any media whether now known or hereafter created without any additional consideration;

4.   understand that neither Participant nor Participant’s Representatives will receive any additional compensation in
     connection with the Event or any of the rights granted by me hereunder; and

5.   have full authority to execute this General Release and do so with full knowledge of the facts and circumstances
     surrounding my participation.

I acknowledge that I have read and fully understand the foregoing.

Name of Participant (please print): ______________________________________________________________
Name of Parent/Guardian (if Participant under 18 years old): _________________________________________
Address of Participant: _______________________________________________________________________
City: ________________________                 State: ____________            Zip Code: __________________________
Age of Participant: ________             Gender of Participant:      Male ( )       Female ( )

Signature of Participant (or Parent/Guardian if under 18): _____________________________ Date:__________

To top