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BALL905 Youth Foundation Player Registration & Waiver Form


Please fill in the following waiver form for BALL905 Youth Foundation. This information will be used to complete registration for your child in our programs. 


WAIVER, RELEASE & INDEMNITY AGREEMENT - LIABILITY, CLAIMS, RISKS & PHOTO RELEASE

I hereby agree, in return for registering as a player/participant of Ball905 Youth Foundation and a member of the Ontario Basketball Association (OBA):

TO RELEASE BALL905 YOUTH FOUNDATION, and their respective directors, officers, employees, agents, volunteers, contractors, representatives, successors, partner clubs (collectively the “Releasees”) from any liability for any loss, damage, injury or expense (collectively “Loss”) that I may suffer as a result of my participation in and transportation to or from any Ball905 Youth Foundation Inc. program, due to any cause, including negligence or breach of contract;

TO WAIVE ANY CLAIM that I have or may have against any or all of the Releasees regarding any matter, including without limitation, any claim arising out of any Ball905 Youth Foundation program;

TO INDEMNIFY THE RELEASEES from any and all claims, actions or Loss resulting in any way from my participation or participation of the child named below in any Ball905 Youth Foundation program;

THIS DOCUMENT SHALL bind my heirs, executors, administrators, assigns and representatives and will have effect throughout my participation and membership in Ball905 Youth Foundation and OBA and, to the extent reasonably necessary to give it effect, thereafter;

THAT I am (or the child named below is) physically fit to participate in any Ball905 Youth Foundation programs; I am a legal guardian or custodial parent of the child named below.

THAT Ball905 Youth Foundation is authorized to take photos and videos of the child named below or me at its programs for publicity and promotional purposes only, and will own the exclusive, universal rights and royalties of said photos and videos in perpetuity.

THAT I, the undersigned parent/legal guardian of the minor participant, authorize Ball905 Youth Foundation staff or representatives to provide first aid or CPR to my child if needed during club activities. If I cannot be reached in an emergency, I consent to my child receiving necessary medical care, including transportation to a medical facility. I agree to provide accurate medical information and update the club on any changes.

I HAVE READ AND UNDERSTAND THIS AGREEMENT. By submitting this form, I acknowledge having read, understood and agree to the above Waiver, Release and Indemnity and further agree to conduct myself in accordance with Ball905 Youth Foundation policies, OBA policies, and Code Of Conduct.

I Agree

July 3, 2025





First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
Parent or Guardian's Email Address
Email
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
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(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information

Are there any medical problems that BALL905 staff should be aware of? (Example: allergies, epilepsy, diabetes, disabilities, injuries, medications, etc.) Please specify if athlete has a life threatening allergy and if an epipen is required.
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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