Basketball Tournament Registration & Waiver Form

Waiver & Release

Assumption of Risks: Participants acknowledge the risk associated with playing basketball and assume full responsibility for any injuries or damages.

Release of Liability: Participants Release and hold harmless EMPOWERHOOD ACADEMY & ONE CULTURE FTP (FOR THE PEOPLE) it's officers, directors, employees, agents and volunteers from any claims of liabilities.

Medical Authorization: Participants authorize medical treatment in case of an emergency.

Contact Phone Number *

COST: $30 per team (7 player Teams) or $5 per player.

You can register your team or you can register alone and team up with other players at the event.

Athletes Name *

Athletes Age *

Athlete Shirt Size *

Small
Medium
Large
XL
2X
3X

Parent/Guardian Full Name *

Relationship To Athlete *

Any Known Medical Conditions/Allergies *

Address *

Email address *

Athletes Gender *

Male
Female
Non-binary

Do You Have A Team? *

Yes
No

Team Name *

**Every Teammate MUST complete this form individually in order to be eligible.

Team Members Name *

Physical Fitness Confirmation (Please Confirm that the athlete is physically fit to participate in tournament.) *

Yes
No

Update Preference (How you would like to receive updates.) *

Email
Text Message
Call

Please confirm that you understand the risks associated with participating in this tournament.

Understanding Of Risks *

Yes
No

Waiver Agreement Confirmation *

I Agree
I Do Not Agree

Certification: Participants certify that the information provided is accurate and true.

Ackowledgement: Acknowledge that they have read, understand, and agree to the terms and conditions of the tournament.

Photography & Videography: Participants Grant permission for photos and videos to be taken and used for promotional promotional purposes.

By signing below, I acknowledge that I have read, understand, and agree to the terms and conditions of EMPOWERHOOD ACADEMY & ONE CULTURE FTP (FOR THE PEOPLE) basketball tournament.

Emergency Contact (Someone Other Than Parent/Guardian) *

By signing your name in the space provided it is equivalent to signing your signature.

Date Of Signature *

Athlete Signature *

Please Upload A Picture of a Parent/Guardians ID/License *

Request for Copy *

Yes
No

Parent Guardian Signature *

Basketball Tournament Registration & Waiver Form

Location Address: 2907 Springwood Dr., Greensboro, NC 27403

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