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Greenhouse Church Youth Basketball Ministry Participant Forms

RELEASE, WAIVER, AND ASSUMPTION OF RISK

Noncommercial / Common-Law Version, section 744.301(3), Florida Statutes. Signed by a natural guardian before the child participates.

1. Nature of the ministry and basis for this release. Greenhouse Church operates the Youth Basketball Ministry as a noncommercial, religious and charitable activity. Any fees charged are used to cover program costs and to further the Church's religious and charitable mission, and the ministry is not operated for profit. I sign this Release as the parent or legal guardian of the child named above (the "Child"), exercising the authority preserved to a natural guardian by section 744.301(3)(d), Florida Statutes, and by Florida common law. To the extent the ministry is instead determined to be a commercial activity provider, I also sign under section 744.301(3)(a)-(c), Florida Statutes.

2. Assumption of the inherent risks of basketball. I understand that basketball training, conditioning, workouts, and games are physical, athletic activities that carry inherent risks, dangers that are characteristic of, intrinsic to, or an integral part of the activity and that cannot be eliminated even when the activity provider acts with reasonable care. These include, without limitation, falls; collisions with other participants, equipment, or fixed objects; sprains, strains, and fractures; overexertion and heat-related illness; and other physical injury, including in rare cases serious injury or death, and include the risk that another participant may act negligently. Knowing and appreciating these risks, I voluntarily choose to allow the Child to participate and I accept these inherent risks.

3. Release of inherent-risk claims (statutory). On behalf of the Child and myself, I waive and release, in advance, any claim or cause of action against Greenhouse Church and its officers, directors, elders, employees, volunteers, and agents (the "Released Parties") for personal injury, including death, or property damage that results from an inherent risk in the activity.

NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN

READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF GREENHOUSE CHURCH USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM GREENHOUSE CHURCH IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND GREENHOUSE CHURCH HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

4. Additional common-law release of ordinary negligence (noncommercial). To the fullest extent permitted by Florida common law for a noncommercial activity provider, and in addition to the assumption and release above, I, on behalf of the Child and myself, further release, waive, and discharge the Released Parties from any and all claims, demands, and causes of action for personal injury, including death, or property damage arising out of or relating to the Child's participation in the activity, including claims caused by the ordinary negligence of the Released Parties. I understand and specifically intend that this release extends to claims based on the Released Parties' own ordinary negligence, and I knowingly give up the Child's right and my right to sue the Released Parties for such ordinary negligence.

Parent/Guardian initials:


5. What this release does NOT cover. This Release does not waive, and expressly excludes, any claim arising from: (a) gross negligence, recklessness, or willful, wanton, or intentional misconduct; (b) child abuse, sexual abuse, sexual misconduct, molestation, or exploitation of a minor; (c) conduct for which Florida law does not permit a pre-injury release; or (d) any duty the Released Parties owe under law for the protection and supervision of minors, which is not limited or waived by this Release.

Parent/Guardian initials:


6. Voluntary agreement, savings clause, and governing law. I have read this Release, or have had it read to me; I have had the opportunity to ask questions; I understand it; and I sign it freely. I understand I may refuse to sign, in which case the Child may be unable to participate. If any provision of this Release is held invalid or unenforceable, the remaining provisions remain in full force. Specifically, if the common-law release of ordinary negligence in Section 4 is held unenforceable, including because the ministry is determined to be a commercial activity provider, then Sections 2 and 3 and the statutory Notice shall remain valid and be given full effect to the maximum extent permitted by law. This Release is governed by Florida law, and venue for any dispute lies in the county in which the ministry operates.

I have read this Release, including the Notice and the additional common-law release in Section 4, and the exclusions in Section 5. I understand I am giving up legal rights, including the right to sue for the Released Parties' ordinary negligence, and I sign voluntarily on behalf of the Child and myself.

Parent/Guardian signature:

Date: November 7, 2026

First Participant's Name
First Name*
Middle Name
Last Name*
First Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
Parent or Guardian's Email Address
Email*
Confirm Email*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
Insurance
Insurance Carrier*
Insurance Policy Number*
Pick-Up Authorization and Physician

Adults authorized to pick up your child, in addition to the parent/guardian above. List a name and relationship for each. Your child will not be released to anyone not listed here.
Primary physician
Physician phone number
Consent to Participate

I am the parent or legal guardian of the child named above. I consent to the child's participation in the Youth Basketball Ministry of Greenhouse Church, including practices, training, workouts, clinics, camps, and games as applicable.

I have received and reviewed the ministry's rules and communication expectations, including the electronic-communication and pick-up/release procedures, and I agree to support them.

I have read and agree to the above. *
Yes
Emergency Medical Treatment Authorization

In the event of injury or illness, I authorize the ministry's approved adults to obtain emergency medical care for my child, including first aid, transport by ambulance or emergency vehicle, and examination and treatment by licensed medical personnel or a hospital, if I cannot be reached promptly. I understand that reasonable efforts will be made to contact me first. I accept responsibility for the costs of such care to the extent not covered by insurance.

Emergency-care limitation. This authorization concerns emergency medical care only. It is not a waiver of any claim and does not limit the Church's duty of care.

I authorize emergency medical care as described above.*
Yes
Concussion and Head-Injury Information

A concussion is a brain injury that can result from a bump, blow, or jolt to the head or body. It can occur in any sport, including basketball, and can be serious even without loss of consciousness.

WARNING SIGNS. Seek care if a child shows any of these:

  • Headache, pressure in the head, dizziness, or balance problems
  • Nausea or vomiting, or sensitivity to light or noise
  • Confusion, memory problems, feeling foggy, or slowed responses
  • Loss of consciousness, even briefly, or seeming dazed or stunned
  • Mood, behavior, or personality changes

MINISTRY PROTOCOL. Any athlete suspected of a concussion or head injury is removed from play immediately, may not return to play that day, and may not return to participation without written clearance from an appropriate healthcare provider. Coaches complete concussion-recognition training, and suspected head injuries are documented and reported to the parent/guardian.

I have read this concussion information and understand the removal-from-play and return-to-play protocol.*
Yes
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*
Relationship*
Phone*
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 Date of Birth*
Date of Birth
Information
Grade (2026-27 school year)*

Allergies (food, medication, insect, other) and the reaction. Leave blank if none.

Current medications and dosages. Leave blank if none.

Chronic conditions (asthma, diabetes, seizures, heart condition, etc.). Leave blank if none.

Activity restrictions or accommodations. Leave blank if none.
First aid and over-the-counter medication. Check each item you authorize ministry personnel to give your child in reasonable doses if needed. Anything left unchecked will not be given.
Acetaminophen (Tylenol)
Ibuprofen (Advil/Motrin)
Antihistamine (Benadryl)
Antibiotic ointment
Other over-the-counter item you authorize. Leave blank if none.

PHOTO, VIDEO & MEDIA RELEASE: From time to time the ministry may photograph or record participants during activities. The ministry will not publish images that are embarrassing, revealing, or that identify a child by full name and location together, and will honor the choice you make below. Recording is never permitted in restrooms, locker rooms, or changing areas.

Photo, video and media release for this participant. Choose one.*
Please select one
I GRANT permission for Greenhouse Church to use photographs and video of my child in ministry and church materials (bulletins, website, social media, and promotional materials), without compensation, consistent with the ministry's media guidelines.
I DO NOT grant permission. My child should not be individually photographed or recorded for publication. I understand incidental appearance in wide group shots may still occur.
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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