Kobe Memory Basketball Club Waiver Form - 19+
WAIVER, RELEASE, AND INDEMNITY
FOR ADULT PARTICIPANTS NINETEEN (19) AND OLDER
(Read Carefully Before Signing)
BETWEEN: Kobe Memory Basketball Club
AND: SIGNEE BELOW
(The Participant)
Kobe Memory Basketball Club requires this form to be completed as a means of confirming that every participant has considered and is aware of the duty they owe to themselves and to all other participants to be informed and aware of the risks inherent in the chosen activity and to carefully consider those risks against their personal ability and level of fitness. This is for the protection of the Participant, other participants, the public, and Kobe memory basketball club.
I, THE UNDERSIGNED Participant, do hereby acknowledge that I am aware that there are elements of risk inherent to this or any activity; that I have informed myself to my own satisfaction of the nature of the risks inherent to the participation in the activities within the facility and agree as follows:
INFECTIOUS DISEASES: I hereby assume the risk of possible exposure to and illness from infectious or communicable viruses and diseases, including but not limited to SARS-CoV-2, Ebola, influenza, and COVID-19 (collectively, “Transmittable Diseases”), which may be suffered or sustained through my participation in the program identified below. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of Kobe Memory Basketball Club, or others. Further, I agree to comply with all applicable municipal, Provincial, and/or Federal regulations, guidelines, orders, directives or rules, as may relate to minimizing the risk of transmission of any Transmittable Diseases and my participation in the activities within the facility.
PARTICIPANT TO INDEMNIFY AND SAVE HARMLESS: That in consideration of the fee to be paid and instruction or other services to be provided, and excepting only the sole negligence of Kobe Memory Basketball Club, I hereby agree to Indemnify and Save Harmless Kobe Memory Basketball Club and its officers, staff, agents, and co-sponsoring organizations from any claims, demands, and causes of action that may arise out of my participation in the activities within the facility.
PARTICIPANT TO RELEASE AND WAIVE CLAIMS: That on behalf of myself, my heirs and assigns, and excepting only the sole negligence of Kobe Memory Basketball Club, I hereby Release, Waive, and forever discharge Kobe Memory Basketball Club and its officers, staff, agents, and co- sponsoring organizations, from all claims, costs, causes of action, or demands that may arise out of any incident, accident, or other occurrence that may result in personal or bodily injury, loss of life, property loss, or any other damages to any person by or through my participation in the activities within the facility.
DIGITAL MEDIA RELEASE: I hereby grant permission to Kobe Memory Basketball Club representatives, to take and use: digital images or video of me for use in website posts and/or social media posts during activities while at Kobe Memory Basketball Club. I further agree that my name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All prints, digital reproductions shall be the property of Kobe Memory Basketball Club.
By signing below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.
Signature : *please provide a digital signature or submit the paper signed version.
