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Kimberly Youth Association
 

Basketball Registration Form

*Please understand that we cannot honor requests for friends to be on the same team or for a certain coach. Please do not ask. We will honor requests for siblings to be on the same team.

Code of Good Sportsmanship
I will encourage good sportsmanship by demonstrating positive support for all players, coaches, and officials at every game, practice, and other youth sporting event. I will place emotional and physical well being of my child ahead of my own personal desire to win. I will support all officials and coaches. I will remember that all games are for the youth and that they are just kids. I will require my child to respect their coach and teammates regardless of race, sex, creed, and ability. I understand that behavior may be remembered long after a score is forgotten and will accordingly control my emotions.

I realize that if I do not uphold these principles, I may be banned from attending practices and games in which my child participates, based on a decision solely made by staff, employees and/or the Kimberly Youth Association.

ASSUMPTION OF RISK, WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT FOR KIMBERLY YOUTH ASSOCIATION, INC.

This Assumption of Risk, Waiver of Liability, and Indemnity Agreement for Kimberly Youth Association, Inc. is made and entered into this day October 20, 2020 on behalf of my minor child (hereinafter referred to as “Participant”) being allowed to participate in certain basketball related events sponsored by Kimberly Youth Association, Inc., an Idaho non-profit corporation.

1. Acknowledgement and assumption of the risk. Participant understands, appreciates and acknowledges that basketball is an inherently dangerous activity, which is accompanied by a substantial risk of physical or emotional injury, death, paralysis, loss, or damage to self, property, and third parties which might result not only from Participant’s own actions, inactions, or negligence, but from the actions, inactions, or negligence of others, the conditions of the grounds or terrain where practices or games are held, or of the equipment used. The risks include, but are not limited to the nature of the activity, acts of other participants, Participant’s own physical condition, acts or omissions; the conditions of the grounds or terrain where basketball games or practices are held; and the unavailability of immediate emergency medical care.

PARTICIPANT HEREBY EXPRESSLY AGREES AND PROMISES TO ACCEPT AND ASSUME ALL THE RISKS ASSOCIATED WITH PARTICIPANT PARTICIPATING IN KIMBERLY YOUTH ASSOCIATION, INC. SPONSORED EVENTS including, without limitation, those set forth hereinabove, even if the risks arise out of the negligence or fault of Kimberly Youth Association, Inc. or its directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors , organizers, advertisers, or agents. Participant’s participation in Kimberly Youth Association, Inc. sponsored events is purely voluntary, and Participant elects to participate in spite of the risks involved therein. Participant hereby assumes full and complete responsibility for any injury or accident which may occur from his or her participation in Kimberly Youth Association, Inc. sponsored events.

2. Representation as to Physical Health. Participant hereby represents and warrants to Kimberly Youth Association, Inc., that he or she is in proper physical condition to participate in basketball practices and games and has no illness, disease or existing injury or physical defect that would be aggravated by his or her participation. Participant shall inform his or her coach if this status changes. Participant hereby agrees and acknowledges that he or she shall be responsible for any and all medical expenses arising from participation in practices and games and while travelling to and from these events. Participant has the right and responsibility to inspect the equipment and facilities prior to events and, if Participant believes that anything may be unsafe, Participant shall advise the coach or supervisor of the condition and may refuse to participate.

3. Release and Waiver of Liability. Participant hereby knowingly and voluntarily releases, forever discharges, and agrees to defend with counsel of Kimberly Youth Association, Inc.’s choosing, and to indemnify and hold harmless Kimberly Youth Association, Inc. and its directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors, organizers, advertisers, agents, servants, representatives, and persons or entities associated directly or indirectly with Kimberly Youth Association, Inc. (the “Releasees”) from any and all claims, causes of action, injuries, damages, lawsuits, liens, judgments, losses and expenses, including, without limitation, attorneys’ fees and costs of litigation, which are in any way connected with or incidental to, or which in any way arise from or relate, directly or indirectly, to Participant’s participation in Kimberly Youth Association, Inc. sponsored events, wherever or however the same may occur, and whether or not said claims arise from the alleged negligence, negligence per se, gross negligence, intentional recklessness, or willful act or omission of Releasees, Participant further agrees that Releasees shall not be responsible for any loss or theft of Participant’s personal property.

4. Liability to Third Parties. Participant hereby agrees that he or she will indemnify and hold harmless the Releasees for all personal injuries, property damages, or other damages to any and all third parties, including but not limited to other participants in Kimberly Youth Association, Inc. sponsored events, which in any way arise from or relate, directly or indirectly, to Participant’s participation in Kimberly Youth Association, Inc. sponsored events, wherever or however the same may occur, and whether or not said claims arise from the alleged negligence, negligence per se, gross negligence, intentional recklessness, or willful act or omission of Releasees.

5. Indemnification of Releasees for Property Loss or Damage. Participant hereby agrees that it shall be liable for, and agrees to indemnify and save Releasees harmless from, and to reimburse Releasees for any expenses incurred relative to, any loss of or damage to the Releasees’ property, including without limitation, any equipment, buildings, or vehicles, which in any way arise from, relate to, are brought as a result of, or are caused by, whether directly or indirectly, Participant’s participation in Kimberly Youth Association, Inc. sponsored events, wherever or however the same may occur.

6. Rules and Regulations. Participant agrees that prior to, and during the entire time that Participant is participating in Kimberly Youth Association, Inc. sponsored events, Participant shall diligently observe and follow policies, rules and regulations, established, adopted or imposed by the Kimberly Youth Association, its coaches and/or /league coordinators.

7. Conduct. Participant agrees to use appropriate personal protective equipment when playing basketball as required by the Kimberly Youth Association or its coaches and/or /league coordinators, including, without limitation closed toed shoes. Participant shall not be under the influence of, nor use alcoholic beverages or unlawful drugs at any time while Participant is participating in Kimberly Youth Association, Inc. sponsored events, nor shall Participant use any legal drugs which would in any way impair Participant’s alertness or physical ability.

8. Insurance. Participant hereby certifies that he or she has adequate insurance to cover any injury or damage that he or she may cause or suffer while participating in Kimberly Youth Association, Inc. sponsored events, or alternatively, Participant agrees to personally bear the costs of such injury or damage. Participant understands that Kimberly Youth Association, Inc. does not provide accident, health, or life insurance coverage for the Participant.

9. Emergency Care and Medical Release. Participant hereby consents to Kimberly Youth Association, Inc. and its directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors, organizers, advertisers, agents, servants, representatives and persons or entities associated directly or indirectly with Kimberly Youth Association, Inc. providing emergency care and/or rendering immediate aide to Participant as might be required at the time for Participant’s health and safety. Participant further consents to all medical and surgical treatment, x-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for Participant’s immediate health and safety.

10. Attorney Fees. Should Kimberly Youth Association, Inc. or anyone acting on its behalf, be required to incur attorney’s fees and costs to enforce this agreement, Participant agrees to indemnify and hold Kimberly Youth Association, Inc. harmless for all such fees and costs.

11. Choice of Law. In the event Participant files a lawsuit against Kimberly Youth Association, Inc., Participant agrees to do so solely in the State of Idaho, County of Twin Falls, and further agrees that the substantive law of the state of Idaho shall apply in that action without regard to the conflict of law rules of the state of Idaho.

12. Severability. BY SIGNING THIS DOCUMENT, PARTICIPANT ACKNOWLEDGES THAT IF ANYONE IS HURT OR PROPERTY IS DAMAGED DURING PARTICIPANT’S PARTICIPATION IN KIMBERLY YOUTH ASSOCIATION, INC. SPONSORED EVENTS, PARTICIPANT MAY BE FOUND BY A COURT OF LAW TO HAVE WAIVED HIS OR HER RIGHT TO MAINTAIN A LAWSUIT AGAINST RELEASEES ON THE BASIS OF ANY CLAIM FROM WHICH PARTICIPANT HAS RELEASED THEM HEREIN. Participant further agrees and acknowledges that the foregoing RELEASE, WAIVER AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State of Idaho, and that if any portion of this agreement is found to be void or unenforceable, the remaining portion shall remain in full force and effect to the maximum extent permitted by law.

13. Use of Photos. Participant gives his/her full permission to Kimberly Youth Association, Inc. and any and its directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors, organizers, advertisers, agents, servants, representatives, and persons or entities associated directly or indirectly with Kimberly Youth Association, Inc. to use any photographs, videotapes, or other recordings of Participant that are made during the course of Participant’s participation in Kimberly Youth Association, Inc. sponsored events.

PARTICIPANT, AND PARTICIPANT’S GUARDIAN IF PARTICIPANT IS A MINOR, HEREBY RESPECTIVELY ACKNOWLEDGES THAT HE OR SHE HAS HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT AND TO ASK QUESTIONS RELATIVE THERETO, HAS READ AND UNDERSTANDS THE TERMS, PROVISIONS, CONDITIONS, AND RELEASES AND WAIVERS AND AGREES TO BE BOUND BY ALL TERMS, PROVISIONS, CONDITIONS, RELEASES AND WAIVERS HEREIN.

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

The Kimberly School District has put in place protective measures to reduce the spread of COVID-19; however, the Kimberly School District cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending activities on the campuses of the District could increase your risk and your child(ren)’s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and on behalf of myself, my child(ren), my and spouse/co-parent of child(ren) voluntarily assume the risk that my child(ren) and I, and any member of my family, may be exposed to or infected by COVID-19 by attending activities on KSD campuses and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 while on KSD campuses may result from the actions, omissions, or negligence of myself and others, including, but not limited to, KSD employees, agents and representatives, volunteers, program participants and their families and/or any other individual who may be present upon school property or in attendance at any school activity.

I voluntarily agree to assume, on behalf of myself, my child(ren), and my spouse/co-parent of child(ren) all risks and accept sole responsibility for any injury to my child(ren), myself and any member of my family, (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I, my child(ren) and/or members of my family may experience or incur in connection with my child(ren)’s attendance in activities or participation in KSD programming (“Claims”). On my behalf, and on behalf of my children and/or members of my family, I will advance no claim and I hereby release, covenant not to sue, discharge, defend, indemnify and hold harmless the KSD, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of KSD, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any KSD activity.

Additionally, it should be noted that the laws of the state of Idaho provide for numerous immunities for schools should something occur to a student or to the family of a student as a result of activities on school property. In addition to this Agreement, these immunities remain intact.

I agree that my child will act in conformance with all safety and sanitation requirements, as well as all social distancing and mask requests. I understand that if my child fails to follow these regulations the ability of my child to participate may be suspended, revoked, or otherwise negatively impacted.

To prevent the spread of COVID-19 your participation is important to help us take precautionary measures to protect you, your Child(ren) and everyone on campus. If you child has been in close contact or been diagnosed with COVID- 19, please honor quarantine standards, and not have your child present at or participating in school activities. If you child has been diagnosed with COVID-19 the District requests that you provide a medical release for your child to return to participation. Likewise, if your child is ill, please do not expose the school’s students and personnel to your child’s illness.

The coaches and activity personnel will have access to thermometers and if a student is not feeling well and has a fever they will be separated and asked to go home until they are fever free for a period of 48 hours.

NOTE: Activities may be suspended consistent with CDC guidelines, if community spread of COVID-19 is identified in the region.

Today's Date: October 20, 2020

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Grade
Unisex Dry fit Shirt Size*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Grade
Unisex Dry fit Shirt Size*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Grade
Unisex Dry fit Shirt Size*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Grade
Unisex Dry fit Shirt Size*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Grade
Unisex Dry fit Shirt Size*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Grade
Unisex Dry fit Shirt Size*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Grade
Unisex Dry fit Shirt Size*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Grade
Unisex Dry fit Shirt Size*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Grade
Unisex Dry fit Shirt Size*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Grade
Unisex Dry fit Shirt Size*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent/Guardian Information

Parent Name

Parent Phone

Parent Name

Parent Phone
Interested in coaching?*
No
Yes

Name of person willing to coach
Assistant Coach?*
No
Yes

Name of person willing to assist coach
Available to help with score table?*
No
Yes

Person willing to help
I hereby represent that I am the authorized parent or guardian of Participant, and as such, that I am legally responsible for the actions or inactions of the Participant, including, but not limited to, any damage to private or public property, and that I am legally responsible for the Participant’s welfare, including personal needs and medical expenses. By signing this Assumption of Risk, Liability Waiver, and Indemnification Agreement for Kimberly Youth Association, Inc., I, both individually, and on behalf of the Participant, acknowledge that I have read this Assumption of Risk, Liability Waiver, and Indemnification Agreement for Kimberly Youth Association, Inc., understand all of its terms, and agree to be bound thereby. I sign this Assumption of Risk, Liability Waiver, and Indemnification Agreement for Kimberly Youth Association, Inc. voluntarily and with full knowledge of its significance. By signing this document, I acknowledge that if anyone is hurt, or property is damaged during my child’s participation in an Kimberly Youth Association, Inc. sponsored event, a court of law may find me and/or my child to have waived our right to maintain a lawsuit against Kimberly Youth Association, Inc. and its directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors, organizers, advertisers, and other agents, estates or executors.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Grade
Unisex Dry fit Shirt Size*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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