Registration Form and Releases
Participant’s Name: ________________________________________________________________________________________
Parent or Guardians Names: _______________________________________________________________________________
Address: _____________________________________________ City:_____________________________ Zip: ______________
School: _____________________________________________________________________ Grade: ________________________
Home Phone: _________________________________ Other Phone: ____________________________________________
Parent’s Email Address(es): _______________________________________________________________________________
Participant’s Height: _______________________ Participant’s Date of Birth: ________________________________
LIABILITY RELEASE AND WAIVER:
I hereby give permission for the minor participant identified above to participate in the Cavalry basketball program.
I understand that basketball practice and competitions are physical activities that present a risk of physical injury to
the minor participant. I further understand that Cavalry Basketball Inc., its directors, coaches, sponsors and
volunteers have no responsibility and assume no responsibility for injuries which my child may suffer while
participating in this program.
I hereby, for myself, my spouse, if any, our heirs and personal representatives, waive and release any and all claims
for damages we may have against Cavalry Basketball Inc., its directors, coaches, sponsors, volunteers, the driver of
any motor vehicle transporting the minor participants, and the agents, representatives and/or assigns of any such
person, for any injury my child may suffer due to participation in this program.
I further understand that Cavalry Basketball Inc. does not carry accident insurance for the benefit of my child and
agree that I will assume full responsibility for my child’s medical expenses and well-being.
Signature of Parent or Guardian: ________________________________________________________Date: _________________________
MEDICAL INFORMATION AND RELEASE
As the parent or legal guardian of the minor‐child participant identified above, I do hereby give authority to
the directors and coaches of the Cavalry Basketball program to obtain all necessary medical assistance for my
child (identified as “Participant” above) in the event of an emergency, including the assistance of a physician
and/or hospital. This authorization is granted in situations where the need for medical care is believed by
Cavalry Basketball directors and/or coaches to be immediate and where a parent cannot be reached
immediately at the numbers provided on the registration form.
Signature of Parent or Guardian:_____________________________________________________________Date: ___________________
Please check any of the following medical conditions which may be applicable (describe if necessary)
_______ allergies (specify: __________________________)
_________ hearing loss
________ daily mediations (specify:__________________)
_______ other (specify: _____________________________)