Basketball Camp Registration Template

Basketball Developmental Training

Henry County Area (Location Disclosed after signup)
Athlete Information
Athlete's Name*

First NameLast Name
Grade*
MaleFemale
Parent/Guardian Information
Name*

First NameLast Name
E-mail*
example@example.com
Home Number
Format: (000) 000-0000.
Cell Number*
Format: (000) 000-0000.
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*
Format: (000) 000-0000.
Alternative Phone Number
Format: (000) 000-0000.
YesNo
If yes, please explain any instructions.*
Informed Consent and Acknowledgement

I, the undersigned parent or legal guardian of the above-named participant, acknowledge that participation in athletic training, sports clinics, strength and conditioning sessions, and related activities conducted by UNCAGED (Under Notable Coaching and Guidance Everyone Develops) involves inherent risks. These risks may include, but are not limited to: falls, collisions, contact with other participants, equipment-related injuries, sprains, strains, fractures, concussions, dehydration, and other serious bodily injury.

I understand that while coaches, trainers, and staff will take reasonable precautions to provide proper supervision and maintain a safe environment, accidents and injuries may still occur.

Voluntarily consent to my child’s participation in all training sessions, practices, clinics, games, and related activities. Acknowledge and assume all risks associated with participation.
Agree that I will not hold liable or bring any claim against:

The coach(es)
Trainer(s)
Staff members
Volunteers
UNCAGED
The facility owners/operators
Any affiliated organizations

For any injury, illness, loss, or damage arising out of participation, except in cases of gross negligence or willful misconduct.

Confirm that my child is physically fit to participate and has no medical condition that would prevent safe participation, or I have disclosed such conditions in writing.
Authorize emergency medical treatment if I cannot be reached.

I understand that this agreement is intended to be as broad and inclusive as permitted under applicable state law.
Media Release & Authorizaton
I, the undersigned parent or legal guardian of the above-named participant, grant permission to UNCAGED (Under Notable Coaching and Guidance Everyone Develops), its coaches, staff, representatives, and affiliates to photograph, record, and/or videotape my child during practices, training sessions, clinics, games, tournaments, and related activities.

I understand that these images, videos, and recordings may be used for lawful promotional and marketing purposes including, but not limited to:

• Social media platforms

• Website content

• Promotional materials

• Flyers and advertisements

• Highlight reels

• Sponsorship or partnership presentations

I acknowledge that:

1. No compensation will be provided for use of such media.

2. UNCAGED may use my child’s first name, image, voice, and likeness in connection with these materials.

3. All media content becomes the property of UNCAGED.

4. I waive any right to inspect or approve the final media product.

I release and hold harmless UNCAGED, its coaches, trainers, staff, facility partners, and affiliates from any claims arising from the use of such media, including claims for invasion of privacy, defamation, or financial compensation.
Confirmation

By acknowledging and signing below, I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.
E-Signature*

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Basketball Developmental Training

Athlete Information

Parent/Guardian Information

Emergency Information

Media Release & Authorizaton

Welcome to UNCAGED

Program Format

Development Focus

Assessment System

Expectations

Payment Methods

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