Britannia Community Centre

When

January 11th, 2024 to April 27th, 2024

Sessions

Fridays: 5:30 pm - 7:00 pm (Girls-Only)
Fridays: 7:30 pm - 9:00 pm (Boys Only)
Saturdays: 5:30 pm - 7:00 pm (Girls-Only)
Saturdays: 7:30 pm - 9:00 pm (Boys Only)

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Sign Up

First Name

Last Name

D.O.B

Basketball Playing Experience

Participating in:

Parent/Guardian Name

Parent/Guardian Email Address

Parent/Guardian Phone Number

Does the participant have allergies, chronic illness, or medical condition that the Night Hoops staff must be aware of? (If yes, please provide info)

Parent/Guardian Permission for Emergency Treatment: In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.

Release of Liability: Release of Liability Night Hoops has the highest level of concern for safety, and we make every effort to create a safe environment for everyone involved in our program. While this is true, injuries/severe injuries/unlikely death are part of sports activities, and I (the parent/guardian) expressly assume the risk of injury, death, and/or illness arising from any cause and agree to waive the right to pursue any claim against the Night Hoops, its staff/volunteers and the persons in charge.

Media Release (**this section must be completed by the parents or guardian)
I hereby grant the Night Hoops Basketball Society (the organization) permission to use my child/ward's likeness in photographs, video recordings or electronic images in any and all of its publications, including website content and social media, without payment or any other consideration. I understand and agree that these materials will become the organization's property and will not be returned. I hereby irrevocably authorize the organization to edit, alter, copy, exhibit, publish or distribute these images to publicize the organization's programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my child/ward's likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to using my image. I hereby hold harmless and release and forever discharge the organization from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

Thank you!
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