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Bay Area Senior Womens Basketball, a California nonprofit corporation (“Organization”) 

Participant Waiver, Release of Liability, Assumption of Risk, Emergency Authorization and Photo/Video Consent 

This waiver shall remain in effect for all current and future Organization activities, programs, clinics, events, scrimmages, tournaments, and basketball sessions unless revoked in writing by the participant. 

1. Assumption of Risk

I understand the nature of basketball and related athletic activities and acknowledge that participation involves inherent risks, including but not limited to falls, collisions, contact with other participants, equipment failure, overexertion, illness, disability, serious bodily injury, concussion, fractures, permanent disability, and death. 

I certify that I am physically able to participate and knowingly and voluntarily assume all risks associated with participation in Organization activities. 

I agree to immediately report any symptoms of concussion and to refrain from participation until medically cleared. 

I acknowledge that risks include travel to and from the Organization’s activities, whether organized or not, and I assume all such risks.

I certify that I am forty (40) years of age or older, or will become forty (40) years of age on or before December 31 of the calendar year in which this Agreement is signed, unless I have been specifically authorized by Bay Area Senior Womens Basketball to participate as an exception to the Organization’s age requirements.

2. Release and Waiver 

On behalf of myself, my heirs, assigns, personal representatives, and next of kin, I hereby release, waive, discharge, and covenant not to sue Bay Area Senior Womens Basketball, a California nonprofit corporation (“Organization”) its officers, directors, volunteers, members, coaches, instructors, sponsors, advertisers, facility providers, and agents from any liability arising from injury, disability, illness, death, property damage, or other losses resulting from my participation in Organization activities. 

This release applies to all Organization activities regardless of the location or facility where such activities occur, including gyms, community centers, schools, parks, tournaments, clinics, practices, scrimmages, and third-party facilities. This release includes claims arising from the negligence, whether active or passive, of the Organization or its representatives, to the fullest extent permitted by California law. I acknowledge that the Organization does not own or control third-party facilities and is not responsible for their condition, maintenance, or safety. 

3. Indemnification and Hold Harmless

I agree to indemnify, defend, and hold harmless the Organization and its representatives from claims, actions, damages, costs, expenses, or liabilities arising from my participation in Organization activities.

4. Compliance with Rules 

I agree to comply with all applicable Organization policies, safety guidelines, and facility rules during participation in Organization activities. 

5. Emergency Medical Authorization 

In the event of injury or medical emergency, I authorize Organization representatives to obtain emergency medical treatment on my behalf if I am unable to provide consent. 

I understand that the Organization is not responsible for any resulting medical expenses and that I remain solely responsible for all medical costs incurred. 

7. Concussion Acknowledgment 

I understand that a concussion is a serious brain injury. I agree to immediately report any suspected concussion or head injury to a Bay Area Senior Womens Basketball organizer and understand that I will be removed from participation if a concussion is suspected. 

I understand that I may not return to participation until I have been medically evaluated and cleared by an appropriate licensed healthcare provider. 

I acknowledge that Bay Area Senior Womens Basketball provides concussion education resources, including the Centers for Diseases Control and Prevention (CDC) HEADS UP materials, and I agree to follow Bay Area Senior Womens Basketball’s concussion safety procedures.

8. Severability Clause 

If any provision of this agreement is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. 

9. Governing Law/Venue 

This agreement shall be governed by and interpreted in accordance with the laws of the State of California. Any legal action shall be brought in the courts located in Santa Clara County, California. 

10. Continuing Agreement 

This agreement applies to all current and future Organization activities unless revoked in writing by the participant. 

ACKNOWLEDGMENT 

I have read this waiver, release of liability, assumption of risk agreement, emergency medical authorization, and photo/video consent. 

I understand that participation in basketball and related activities involves inherent risks, including the possibility of serious injury or death. 

I voluntarily agree to these terms and sign this agreement freely and voluntarily. 

I understand that the Organization does not provide medical, health, disability, or accident insurance coverage for participants, and I am responsible for maintaining my own insurance and paying medical expenses. 

Date: August 27, 2026

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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:*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
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*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information
6. Photo and Video Release - I consent to and authorize the Organization to photograph, videotape, record, and use my image, likeness, voice, and participation in Organization activities for educational, promotional, fundraising, website, and social media purposes without compensation.
Check here if you do NOT wish to be identified by name in social media posts.
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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