Play 4 Him Academy LLC · Just Stay Humble Basketball Training
I acknowledge that even with the best coaching, using the most advanced protective gear and strictly observing the safety rules, injuries are still possible. On rare occasions these injuries can be so severe that they result in disabilities, or death. I acknowledge that I have read and understand these risks.
Having been informed of the above risk I hereby give my consent for participation in Play 4 Him Academy LLC camps or one-on-one/group coaching.
In consideration of acceptance to participate, I release and agree to hold blameless Coach Jeramie Hinote, the Play 4 Him Academy LLC, and anyone associated with the Play 4 Him program from any claims on account of injuries, damages, and losses which may be sustained by my son/daughter while participating in practices, camp activities, traveling/transportation and anything else in association with Play 4 Him Academy LLC. I am voluntarily requesting permission for my child to participate in Play 4 Him Academy LLC program(s).
MEDICAL HISTORY: I further certify that the participant's present level of physical condition is consistent with the demands of active participation in the game of basketball. Following is a complete list of any known health conditions that might affect my ability to participate.
EMERGENCY CARE: I authorize the treatment by a qualified and licensed medical doctor in the event of a medical emergency that, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed.
INSURANCE: I understand that Play 4 Him Academy LLC carries no insurance of any kind to cover medical expenses which may occur from participation in the basketball camps, one-on-one/group coaching, traveling and anything else in association with Play 4 Him Academy LLC activities, and will not be responsible for any such expenses. I agree that I have adequate insurance to cover my child's medical needs should any be incurred, or I will assume all such expenses personally.
I have read and fully understand the above program details, Parent Consent, Waiver and Release of All Claims, Permission to Secure Treatment, and Insurance.
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