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LOCATION *
PARENT OR GUARDIAN NAME *
PARENT OR GUARDIAN NAME
Phone
Phone
Address
Address
1st child's name
1st child's name
2nd child's name
2nd child's name
3rd child's name
3rd child's name
Waiver *
RELEASE AND WAIVER OF LIABILITY I give permission for my child to participate in all activities involved with this program, and hereby release NHB, its facilities, staff, and proprietors from any liability or responsibility from any injury or illness that may occur during participation. I am aware of the inherent risks involved with the physical nature of this program, and hereby attest that my child has been deemed by a physician to be in suitable physical and medical condition for participation in rigorous physical activity. If I am unable to be reached in the event that my child should require emergency medical treatment or care, I authorize NHB and its representatives to seek appropriate medical treatment or care for my child on my behalf.
Photo consent *
Photo Consent * PHOTO CONSENT I hereby give permission to New Horizon Basketball Academy to include my child in photos and video taken by the New Horizon staff. I understand these photos will be used for publicity and promotional purposes only (e.g. website, social media, brochures, educational or community events, etc), but no names will be associated with pictures and/or video without permission from parent(s) or guardian(s).