NAB Champions Registration

Dates (Saturday Mornings): January 17th January 24th January 31st February 7th February 14th February 21st Times: GROUP 1 10:00am – 11:00am GROUP 2 11:00am – 12:00pm Location: The Pen Ryn School 235 S Olds Blvd Fairless Hills, PA 19030 Cost: FREE for all participants

Guardian Name

First

Last

Phone Number

Child Name

First

Last

Child Name # 2 (If Applicable)

First

Last

Child Name #3 (If Applicable)

First

Last

Child Age (Please add all ages if signing up multiple children)

What session(s) would you like to sign up for? (Please check all that apply)

Group 1: Ages 12 and Under – 10:00am – 11:00am
Group 2: Ages 13 and Up – 11:00am – 12:00pm

multiple (Please

Marketing Waiver

Acknowledge

I hereby give NAB permission to use photographs and videos of my child for marketing and public relations materials including the website and social media accounts.

NAB Participant Release and Waiver of Liability Agreement

Acknowledge

I acknowledge that I have voluntarily applied to participate in the following activity of NAB: Basketball Clinics. I am aware that as a volunteer applicant that these activities are hazardous activities and that I could be seriously injured or even killed. I am aware that NAB does not have the personnel or expertise to provide the necessary supervision to address any special needs for this applicant including, but not limited to allergies, asthma, medical issues, etc. I am voluntarily participating in these activities on the condition that I will provide individual supervision for the child during NAB activities with knowledge of the danger involved and agree to assume any and all risk of bodily injury, death, or property damage, whether those risks are know or unknown. As consideration for being permitted by NAB to participate in these activities and use of premises and facilities, I forever release NAB, the respective employees, volunteers, and representatives (collectively releases) from any and all actions, claims, or demand that I, my assignees, heirs, distributes, guardians, next of kin, spouse, and legal representatives now have or may have in the future, for injury, death, or property damage related to my participation in these activities, the negligence or acts, whether directly connected to these activities or not, and however, caused by any Releasee, or the condition of the premise where their activities occur, whether or not I am then participating in the activities. I also agree that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representative will not make claim against, sue, or attach property of any Release in connection with any of the matters covered by the foregoing release. By selecting the check box during the registration process to acknowledge that I accept the waiver, I am agreeing to and verifying that the dangers of the activities and the significance of this release and waiver were explained to the participant and the participant understood them.