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BASKETBALL WAIVER FORM

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					                                  BASKETBALL WAIVER FORM
Player’s Name

Address

City                     State         Zip             E-Mail

Player’s Height                  Player’s Age                     Player’s Grade

Parent’s Cell Phone #                           Home Phone

Work Phone                                      Health Ins. Co.

Health Ins. Phone                               Insurance Policy #



In case we are unable to contact parent, please list any emergency contact who agrees to be
responsible.

Emergency Contact name                                            Phone

Waiver: If any emergency occurs, I authorize NEXT PLAY BASKETBALL and/or NEXT PLAY
BASKETBALL representative to take all proper action and use the emergency service available at
the nearest hospital, if necessary. I understand my personal insurance will be used in this case
(the proper calls will be made to you before any medical attention is given). In case of extreme
emergency, I authorize the emergency personnel to take proper action.

Signed                                                            Date
                  (Must be signed by parent or guardian)

Waiver: If and for consideration of my child’s participation in the NEXT PLAY BASKETBALL activities
checked in this document, I hereby agree and promise that I will not hold NEXT PLAY BASKETBALL
and/or NEXT PLAY BASKETBALL representatives responsible for any loss, damages, or personal
injuries that my child may receive as a result of participation. This waiver of liability expressly
includes to and from, or in connection with F. Michael Smith, in any vehicle operated by NEXT
PLAY BASKETBALL or NEXT PLAY BASKETBALL representative.

Signed                                                            Date
              (Must be signed by parent or guardian)
NEXT PLAY BASKETBALL                WAIVER FORM                                    June 7, 2010
AAU CLUB # - PABA4A4KA0

				
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Description: Basketball is the speed, flexibility, strength combination, people should focus on full-speed sprint through the exercise, jumping exercises and strength training the core area of ??waist to stimulate their maximum potential. Want good basketball ability, we must exercise a great athletic ability: bounce, strength, flexibility and so on.