Sunday Morning
Alumni Basketball


Registration

First Name:  
Last Name:  
Address:  
City:  
State:  
Zip:    
Email Address:    
Email Address Confirmation:  
Phone:  
Alum: 
If Yes, Graduation Year:
If No, Campbell Hall affiliation:
(Choose One)





Other:
If Friend, Name of Alum:

Medical History

Do you suffer from any medical conditions that would inhibit your ability to participate?  
If Yes, Explain:
Are you allergic to medications? 
If Yes, please indicate which ones:
Name of Physician or Doctor:  
Phone of Physician or Doctor:  
Health Insurance Provider:  

Emergency Contact Information

Person to contact in case of emergency:
Name:  
Phone:  
Relationship to Player:  

Release:

Release: The undersigned releases Campbell Hall, as well as its officers, employees, and agents and agrees not to sue them on account of the activity, including those based on death, bodily injury or property damage whether or not caused by the acts, omission or other fault of the parties being released.

Waiver: The undersigned waives the protection afforded by any statute or law in any jurisdiction including the California Code 1542 whose purpose, substance, and/or effect is to provide that a general release shall not extend to claims, material, or otherwise which the person giving the release does not know of or suspect at the time of executing the release. This means, in part, that the undersigned is releasing unknown future claims.

Indemnify and Defend: The undersigned agrees to INDEMINFY AND DEFEND Campbell Hall, its officers, employees, and agents (hereinafter jointly referred to as “indemnitee”) of each against, and hold them harmless from any or all claims, causes of action, damage judgments, costs or expenses, including attorney fees which may arise from the activity or this agreement which include but are not limited to damages to or destruction of any property of the indemnitee, of any others, injury or death of the undersigned or anyone else or any liability arising from the act or negligent act of indemnitee, the undersigned or anyone else.

Pay: The undersigned agrees to pay for any or all damages to any property or indemnitee caused by the undersigned either negligently, willfully, or otherwise.

Representatives: The undersigned enters into this agreement for himself/herself, his/her heirs, assigns and legal representatives.

Emergency Treatment Consent: The undersigned, as a participant in the subject activity, herby consents to medical treatment in a medical emergency where the undersigned is unable to consent to such treatment.

Player's Name:  
Date:  
I agree to all liability risks, terms, and conditions on this application (Required to process application)

Cost Information

Cost: $150 per person / Alumni, Parent and Spouses of Alumni / Friends of Alumni