Waiver and Hold Harmless Form

Ignite Basketball Academy, LLC

RISK AND WAIVER OF LIABILITY FORM

As the legal guardian of _________________________________________________________, I hereby consent to the aforementioned person participating in the Ignite Basketball Academy, LLC program including but not limited to; tryouts. I recognize that potentially severe injuries can occur in any activity that is associated with basketball and youth sports.

I understand that this is the express intent of the Ignite Basketball Academy, LLC, to provide for the safety and protection of my child and, in consideration for allowing my child to tryout and/or play for the James Valley Thunder, I hold the club totally harmless.

I hereby forever release Ignite Basketball Academy, LLC and its Directors, Coaches, Trainers and staff, and/or the Mobridge-Pollock School District facilities, and any other facility that maybe used by Ignite Basketball Academy, LLC, its officers, employees, coaches and owners from all liability for any and all damages and injuries suffered by my child while under the instruction, supervision or control of any of the above so mentioned.

As legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while trying out for the Ignite Basketball Academy, LLC and/or any facility used by the Ignite Basketball Academy, LLC and its officers, employees, coaches and owners.

In case of an emergency, I authorize Ignite Basketball Academy, LLC staff to administer first aid to my child/or take my child to a physician or hospital for further treatment. This acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent.