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Player First Name:

Player Last Name:

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Date of Birth:

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AAU Team name (optional):

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Parents First Name:

Parents Last Name:

Parent/Guardian Phone:

Parent/Guardian Email:

Waiver of claims:

I, as a parent or guardian, hereby give permission for my child to participate in the Alpha Basketball Academy and acknowledge the fact that he/she is physically able to participate in camp activities. I hereby authorize the staff of the Alpha Basketball Academy to act for me according to their best judgment in any emergency requiring medical attention, and acknowledge that I will be responsible for any cost (through family medical insurance or otherwise) incurred due to sickness or injury to my son or daughter. I hereby waive any claim that I might have against the Alpha Basketball Academy and the institution to participate in the Alpha Basketball Academy and the institutions associated to facility use and rental. Alpha Basketball Academy has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported. Type first and last name above to acknowledge and approve waiver of claims:

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