Release Form

Players Name: _____________ Boy / Girl (circle one) Grade in Fall 2018: _______

As parent/guardian of (player’s name) _______________________, who is entering _____th grade this fall, I hereby give my consent to his/her participation in the Acton-Boxborough Travel Basketball Program including try-outs, practices, games/scrimmages, any other team functions, as well as transportation to and from all above named activities. I do hereby waive, release, absolve from liability, indemnify and agree to hold harmless for all damages and loss of equipment, direct or consequential, the directors, officers, coordinators, coaches, staff, volunteers, and other participants of Acton-Boxborough Travel Basketball Program and the Central Massachusetts Youth Basketball League and the Metrowest Basketball League (along with their directors, staff, coaches, and volunteers), the Acton-Boxborough Regional School District (along with their school committees, staff, and volunteers) and Acton-Boxborough Community Education as well as those transporting the above named child to or from the activities for any injuries sustained by him/her as a result of their participation in the program.

I understand that decisions regarding player selection, playing time, team management and team and program philosophies are 100% determined by coaches and directors or appointees by coaches and directors and are non-negotiable outside of that group.

I hereby certify that the above named child is in good physical health and is physically capable of participating on a basketball team.

I understand I may assume responsibility for any damage the above named child may cause to any school or other facility while a member of the team.

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Signature of Parent or Legal Guardian                                                               Date