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Game Over NYC Basketball Waiver
This Liability Release, Waiver, Discharge and Covenant not to Sue, (hereinafter referred to as “Release”),
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First & Last name of the registrant/participant
First Name
Last Name
the “Registrant/Participant”, whose address is
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
acknowledges that basketball is a contact activity (Activity) and that they understand the dangers, hazards, and risks inherent to the Activity and all associate Activities. The undersigned releases, waives, discharges and covenants not to sue Game Over Sports and Entertainment, LLC. and the Stuy Dome (hereinafter referred to as “Releasees”); their directors, officers, administrators, agents, staff, coaches, employees, volunteers, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the Event of each and everyone of the aforementioned entities against all causes of action, claims, suits, controversies, agreements, promises, judgments, demands or claims for losses or damages on account of injury, including death or damage to property, whatsoever, that the undersigned’s spouse, heirs, executors, administrators, successors, assigns have or hereinafter, at any time, shall or may have arising due to negligence or otherwise. These dangers, hazards, and risks inherent in the Activity of basketball include, but are not limited to, impact with other players; court, basket supports, net supports and poles, netting, seating, walls, fences and any and all equipment associated with the Activity; and all additional equipment utilized in the furtherance of the Activity. Possible temporary or permanent serious injuries may be, but not limited to, cuts, sprains, fractures, brain or spinal injury, paralysis, or even death. The undersigned acknowledges that the types of injuries and harm mentioned in the preceding paragraph of this Release can arise from a wide spectrum of causes in regard to the sport of basketball including, but not limited to: head injuries suffered by players impacting each other; basket supports, net supports and poles, netting, fences, the ground, equipment both permanent and temporary within the area of play; injuries caused by poor court conditions including wet or uneven flooring, potholes, cracks, holes and the like, poor lighting, and protruding structures; getting hit by motor vehicles and other vehicles in parking lots and roads near participation area; violent or rough play; player fights; or negligence or misconduct by coaches, instructors, assistants, volunteers, counselors, parents, referees or other players. The undersigned acknowledges that participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, knowingly and freely assumes all such risks, both known and unknown, even if arising from the negligence of themselves or others, and assumes full responsibility for their participation; and, willingly agrees to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, the undersigned observes any unusual or significant hazard during the undersigned’s presence or participation, the undersigned will remove themselves from participation and bring such to the attention of the nearest official immediately.
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(Initial here) By initialing to the left I am certifying that the Registrant is in normal health and is capable of participating safely in the Event.
(Initial here) By initialing to the left I am authorizing the Event Directors to act in my behalf in accordance with their best judgment in case of an emergency and to obtain necessary medical treatment for myself with the understanding that the family will be notified as soon as possible.
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Cell Phone
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(###)
###
####
Email
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Emergency Phone
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(###)
###
####
(Initial here) By initialing to the left I acknowledge that in return for the goodwill, public service, and community aid provided by Game Over Sports and Entertainment, LLC. and the Stuy Dome, which I support and from which I received benefit, I am authorizing and granting permission to use the Registrant’s name, to take and publish photographs, videotapes or motion pictures of him/her which may include his/her voice, in any media for legitimate purposes. I release all rights to such photographs, videotapes, motion pictures and recordings. I acknowledge that Game Over Sports and Entertainment, LLC. and the Stuy Dome are sole owners of all rights arising out of their use for all purposes. I understand that I shall receive no compensation for their use from what source whatsoever.
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(Initial here) By initialing to the left I understand that should the Registrant act in poor behavior as determined by Game Over Sports and Entertainment, LLC. the Stuy Dome, their directors, officers, administrators, agents, staff, coaches, employees, or volunteers, as a participants and understand that the Registrant does not correct their behavior as requested to maintain acceptable standards, he/she will forfeit his/her involvement with the program.
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By signing below I acknowledge reading and agreeing to all terms of this Liability Release, Waiver, Discharge and Covenant not to Sue.
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Signature of Adult Participant / Coach / Volunteer
First Name
Last Name
Date
*
MM
DD
YYYY
Thank you!