Waiver | Pure Youth Basketbal

Pure Youth Basketball Liability Waiver

Child's First name

Child's Last name

Child's Date of Birth

Enter Grade Level

I give my permission to have my child photographed during camp

I permit my child to participate in physical activities during basketball training?

Yes

Please specify anything we should know about

Parent/Guardin signature

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Thanks for submitting!

Pure Youth Basketball Liability Waiver

Contact Us

810-214-2806

pureyouthbasketball@gmail.com