Hoops4Health Waiver Form
TODAY'S DATE: March 19, 2024
I hereby authorize (the child), to participate in the programs of Hoops 4 Health, Inc. (Hoops). Further, I authorize Hoops to act for me and exercise best judgment in any emergency requiring medical attention for the child. I hereby waive and release Hoops from any and all liability for any injury or illness incurred by the child while participating in any program of Hoops. I understand that Hoops 4 Health, Inc. (Hoops) may take photographs and/or video of the child while participating in any and all activities connected with the programs of Hoops. Accordingly, I agree that Hoops retains the right to use for publicity and advertising any such photographs. As the parent or guardian of the child, I recognize and acknowledge that there are certain risks of physical injury and agree to assume the full risk of any injuries, including death, damages or loss which the child may sustain as a result of participating in any and all activities connected with the programs of Hoops. Accordingly, I agree to waive and relinquish all claims I or the child may have a result of participation in any program of Hoops against Hoops, its officers, agents, and employees from any and all injuries, including death, damage or loss which I or the child may have or which may accrue as a result of childs participation in any program of Hoops.
Does the child have: (check all that apply)