Player Name *

First Name

Last Name

Player Date of Birth *

MM

DD

YYYY

Parent Name *

First Name

Last Name

Parent Phone *

(###)

###

####

Parent Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Teammate Request 1

Select up to 3 teammates. You can sign up as an individual and we will place you on a team at the tournament.

First Name

Last Name

Teammate Request 2

First Name

Last Name

Teammate Request 3

First Name

Last Name

Waiver and Release of Liability *

I hereby agree, in becoming a member of Rise Basketball Player Development (RBPD): • TO RELEASE RBPD, event organization bodies, sanctioning bodies and RBPD sponsors and their respective directors, officers, employees, agents, volunteers, contractors, representatives, successors or assigns (collectively the 'Releasees') from any liability for any loss, damage, injury, or expense (collectively "Loss") that I may suffer as a result of my participation in and transportation to or from any RBPD program, due to any cause, including negligence or breach of contract; • TO WAIVE ANY CLAIM that I have or may have against any or all of the Releasees regarding any matter, including without limitation, any claim arising out of any RBPD program; • TO INDEMNIFY THE RELEASEES from any and all claims, actions, or Loss resulting in any way from my participation or participation of the child named in any RBPD program; • THIS DOCUMENT SHALL bind my heirs, executors, administrators, assignee and representatives and will have effect throughout my membership in the RBPD and, to the extent reasonably necessary to give it effect, thereafter; • THAT I am (or the child named is) physically fit to participate in any RBPD programs; I am a legal guardian or custodial parent of the child named below. • THAT the RBPD is authorized to take photos of the child named below or me at its programs for publicity and promotional purposes only. I HAVE READ AND UNDERSTAND THIS AGREEMENT. By submitting this application, I acknowledge having read, understood and agree to the above Waiver, Release and Indemnity.

I agree