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Select Your Event:
---Youth Winter Bball LeagueMidnight Bball ProgramMarriott Round Ball ClassicMemphis In MayTony Delk TourneyWho's Got Next?Bluff City LiveKid JambalympicsFamily JambalympicsMidnight 5k

Team Name:

Gender:
Youth Boys

Age:
2nd (8U)3rd (9U)4th (10U)5th (11U)6th (12U)7th (13U)8th (14U)9th (15U)10th (16U)11th (17U)

Coach Name:

Email:

Address:

City:

State:

Zip:

Phone (ie., 6155551234):

Alternate Phone (ie., 6155551234):

Please rate your team's experience:
ABC

Can you play Friday night?:
YesNo

Special Requests, Medical, etc. (optional):

Comments:

Release of Liability – Jambalaya Sports & Entertainment, LLC

In consideration for the opportunity to participate in the above activity, the Participant acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The Participant accepts personal financial responsibility for any injury sustained during the activity or during transportation to and from the activity. Further, the Participant promises to indemnify, defend, and hold harmless the activity sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Sponsor”) for any injury related directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the Sponsor or otherwise.

1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately; and,
4. Players or coaches who engage in fighting or obscene behavior or language will be immediately removed from competition.
   I hereby assume the risk of any and all injury and damage resulting from participation in sports activities and will not hold Midnight Basketball League/Program or Jambalaya Sports & Entertainment or the facility of play liable under any circumstances.
   I give my consent to being photographed by Midnight Basketball League/Program or Jambalaya Sports & Entertainment, the facility of play and any other representatives, and allow for any pictures to be displayed/used by Midnight Basketball League/Program or Jambalaya Sports & Entertainment, including but not limited to Midnight Basketball League/Program or Jambalaya Sports & Entertainment website, promotional and marketing materials, and social networking (i.e., Facebook)

5. I, for myself and on behalf of my team/players/heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS JAMBALAYA SPORTS & ENTERTAINMENT LLC, MIDNIGHT BASKETBALL LEAGUE/PROGRAM, INC sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss damage to person or property, WHETHER ARISING FROM NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO IT, AND AGREE TO IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

By submitting this form, I am accepting the above terms as a Release of Liability