Winter Break Youth Camp

IN CONSIDERATION of __________(name_stated_above)______________, my child, being allowed to participate in any UNLOCKED POTENTIAL event and activities, the undersigned acknowledges and agrees that: I ACKNOWLEDGE AND AGREE I understand the nature of basketball activities and any sports activity is a test of a person's physical abilities and it carries with it the potential for serious injury and even death. I HEREBY agree to assume all of the risks of having my minor child participate in activities and events by Unlocked Potential. I realize liability may arise from negligence or carelessness on the part of the persons or entities being released or because of their liability without fault. I CERTIFY that my child is physically fit to participate in various events by Unlocked Potential or sponsored events, and has not been advised otherwise by a qualified medical person. I further agree and warrant that if at any time I believe the conditions to be unsafe, I will immediately discontinue further participation in the activity. I ACKNOWLEDGE that this Release of Liability form will be used by the event holders, sponsors and organizers of the event in which they participate and it will govern my actions and responsibilities at said events. In consideration of my child's participation, I hereby take action for myself and child, my executors, administrators, heirs, next of kin, successors and assigns as follow: (A) Waive, Release and Discharge from any and all liability for death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me including attorney's fees, litigation costs and my traveling to and from events. I indemnify and hold harmless Unlocked Potential, its directors, officers, employees, volunteers, representatives and agents, sponsors, event staff, event volunteers, property owners from any and all liabilities or claims made as a result of participation in Unlocked Potential. I HEREBY consent medical treatment of my minor child which may be deemed advisable in the event of injury, accident and/or illness during evens/activities. I UNDERSTAND that my child may be photographed, videotaped or have my likeness reproduced. I agree to allow my or my child's likeness to be used for legitimate purposes by the event holders, producers, organizers and/or assigns. This Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum permissible under applicable law. I further agree to abide by all the rules and regulations as set forth by Unlocked Potential. I hereby certify that I have read this document and fully understand it's contents and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by the law and agree that if any portion of this agreement is held to be invalid, the balance notwithstanding, shall continue in full force and effect.

Does Your Child Have Any Pre-Existing Injuries?