Participation Agreement, Medical Release & Liability Waiver

1. Covered Activities

This Agreement applies to all Westlake Hoops activities, events, programs, practices, training sessions, competitions, and related activities, whether organized, hosted, sponsored, operated, supervised, promoted, attended, or participated in by Westlake Hoops, including but not limited to:

• Basketball practices, team practices, small group training, private one-on-one training, skills classes, clinics, camps, open gyms, scrimmages, games, leagues, showcases, tryouts, evaluations, workouts, conditioning sessions, athletic development sessions, sports performance training, and related basketball or athletic instruction;
• First-party tournaments, Westlake Hoops-hosted events, internal competitions, special events, team activities, team meetings, parent meetings, award events, and program gatherings;
• Third-party tournaments, leagues, showcases, camps, clinics, games, competitions, and events in which Westlake Hoops teams, coaches, or Participants may participate;
• Warmups, cooldowns, stretching, sideline activities, team huddles, film review, team-building activities, arrival, departure, waiting periods, transitions between sessions, and time spent before, during, or after any Westlake Hoops Activity;
• Use of basketballs, cones, ladders, resistance bands, weights, agility equipment, training aids, scoreboards, benches, bleachers, seating areas, locker rooms, restrooms, hallways, parking lots, entrances, exits, and other facility areas.

All of the above are collectively referred to as the "Activities."

2. Covered Locations and Facilities

This Agreement applies regardless of where the Activities occur, including but not limited to:

• Public school gyms, private school gyms, elementary school gyms, middle school gyms, high school gyms, college or university gyms, and school athletic facilities;
• Church gyms, synagogue gyms, faith-based facilities, community centers, recreation centers, YMCA-type facilities, private gyms, athletic clubs, fitness facilities, training centers, sports complexes, fieldhouses, and multipurpose courts;
• Tournament gyms, league facilities, event venues, rented courts, shared-use gyms, third-party host facilities, and facilities operated by other teams, leagues, clubs, tournament operators, schools, churches, municipalities, or private organizations;
• Outdoor courts, parks, playgrounds, driveways, sidewalks, parking lots, common areas, courtyards, entrances, exits, hallways, locker rooms, bathrooms, bleachers, spectator areas, concessions areas, and surrounding premises;
• Any other facility, property, venue, or location used in connection with Westlake Hoops Activities, whether owned, leased, rented, borrowed, reserved, assigned, or otherwise made available to Westlake Hoops.

Parent/Guardian understands that Westlake Hoops may not own, control, inspect, maintain, operate, or supervise all facilities or locations where Activities occur, including third-party tournament venues, rented facilities, school gyms, church gyms, shared-use facilities, and facilities operated by outside organizations.

3. Parent/Guardian Authority and Participant Information

Parent/Guardian certifies that they are the lawful parent or legal guardian of the Participant and have full legal authority to enter into this Agreement on behalf of the Participant.

Parent/Guardian agrees to provide accurate and complete information regarding the Participant, including medical conditions, allergies, medications, emergency contacts, physician information, physical limitations, behavioral concerns, prior injuries, concussion history, and any other information reasonably necessary for the Participant's safe participation.

Parent/Guardian agrees to promptly update Westlake Hoops if any information changes. Parent/Guardian may update this information at any time from the My Account area after signing in.

4. Medical Release and Emergency Authorization

Parent/Guardian authorizes Westlake Hoops, including its owners, members, managers, directors, officers, coaches, employees, contractors, volunteers, representatives, agents, and other authorized personnel, to act on Parent/Guardian's behalf in seeking emergency medical care, first aid, emergency transportation, evaluation, or treatment for the Participant if Parent/Guardian cannot be reached in a timely manner or if immediate action is reasonably believed to be necessary.

Parent/Guardian authorizes any licensed physician, hospital, emergency medical technician, athletic trainer, urgent care facility, medical facility, or other healthcare provider to evaluate, treat, and provide emergency medical care to the Participant as deemed necessary.

Parent/Guardian understands and agrees that medical treatment may include, but is not limited to, first aid, CPR, emergency transportation, diagnostic testing, X-rays, medication, stitches, casting, splinting, surgery, or other medical procedures deemed necessary by medical professionals.

Parent/Guardian agrees to be solely responsible for all medical, ambulance, emergency transportation, hospital, physician, therapy, rehabilitation, and related expenses incurred as a result of the Participant's injury, illness, or medical condition, whether or not such expenses are covered by insurance.

Parent/Guardian understands that Westlake Hoops does not provide health insurance, accident insurance, or medical coverage for Participants unless separately stated in writing.

5. Physical Fitness and Medical Clearance

Parent/Guardian certifies that the Participant is physically fit and able to participate in basketball, athletic training, conditioning, competitions, and related Activities.

Parent/Guardian certifies that the Participant has no medical, physical, emotional, behavioral, or other condition that would make participation unsafe for the Participant or others, unless such condition has been disclosed in writing to Westlake Hoops.

Parent/Guardian acknowledges that it is Parent/Guardian's responsibility to consult with a licensed physician before allowing the Participant to participate if there is any question regarding the Participant's health, physical condition, injury status, or ability to safely participate.

Parent/Guardian agrees that the Participant will not participate while sick, injured, under medical restriction, recovering from a concussion, experiencing symptoms of illness, or otherwise unable to safely participate.

6. Concussion, Head Injury, and Return-to-Play Acknowledgment

Parent/Guardian understands that basketball, athletic training, and sports participation involve risks of head injuries, concussions, and other serious injuries.

Parent/Guardian agrees that if the Participant shows signs or symptoms of a concussion, head injury, significant pain, illness, or other concerning condition, Westlake Hoops may remove the Participant from participation.

Signs or symptoms may include, but are not limited to, headache, dizziness, confusion, nausea, vomiting, blurred vision, balance problems, memory issues, sensitivity to light or noise, unusual behavior, loss of consciousness, or complaints of not feeling right.

Parent/Guardian agrees that the Participant may not return to participation after a suspected concussion or significant head injury unless and until the Participant has been evaluated and cleared in writing by an appropriate licensed healthcare provider.

Parent/Guardian understands that final responsibility for medical decisions, injury evaluation, and return-to-play clearance rests with Parent/Guardian and qualified medical professionals, not Westlake Hoops.

Parent/Guardian agrees to immediately notify Westlake Hoops of any concussion, suspected concussion, head injury, or medical restriction affecting the Participant's ability to participate.

7. Assumption of Risk

Parent/Guardian understands and acknowledges that participation in basketball, sports training, athletic development, and related Activities involves inherent and unavoidable risks, including but not limited to:

• Physical contact, collisions, falls, slips, trips, cuts, bruises, sprains, strains, fractures, dislocations, concussions, head injuries, eye injuries, dental injuries, muscle injuries, ligament injuries, tendon injuries, joint injuries, and other bodily injuries;
• Overexertion, dehydration, heat exhaustion, heat stroke, fatigue, dizziness, fainting, asthma-related incidents, allergic reactions, seizures, cardiac events, and other medical events;
• Contact with basketballs, equipment, walls, floors, bleachers, chairs, tables, doors, scoreboards, training aids, other players, coaches, referees, spectators, or facility fixtures;
• Risks related to court conditions, flooring, wet spots, uneven surfaces, poor lighting, facility defects, equipment defects, crowding, weather, parking lots, entrances, exits, and shared-use facilities;
• Risks related to negligent or intentional acts of other Participants, spectators, coaches, referees, tournament operators, facility owners, facility users, or third parties;
• Risks related to travel, arrival, departure, parking, drop-off, pickup, and movement around facilities;
• Loss, theft, or damage to personal property;
• Exposure to contagious illnesses, viruses, bacteria, or communicable diseases;
• Other risks known or unknown, foreseeable or unforeseeable, that may arise from participation in or attendance at the Activities.

Parent/Guardian voluntarily assumes all risks associated with the Participant's participation in the Activities.

8. Liability Release and Waiver, Including Negligence Release

IMPORTANT NOTICE: THIS SECTION CONTAINS A RELEASE AND WAIVER OF LIABILITY, INCLUDING A RELEASE OF CLAIMS ARISING FROM THE ORDINARY NEGLIGENCE OF WESTLAKE HOOPS AND OTHER RELEASED PARTIES, TO THE FULLEST EXTENT PERMITTED BY TEXAS LAW.

In consideration of the Participant being permitted to participate in Westlake Hoops Activities, Parent/Guardian, on behalf of themselves, the Participant, and their heirs, executors, administrators, successors, and assigns, hereby releases, waives, discharges, and agrees not to sue Westlake Hoops, LLC, its owners, members, managers, officers, directors, employees, contractors, coaches, volunteers, agents, representatives, affiliates, sponsors, partners, successors, and assigns, as well as any facility owners, facility operators, schools, churches, tournament operators, event hosts, landlords, property owners, officials, referees, vendors, and other third parties involved in providing facilities or services for the Activities, collectively the "Released Parties."

This release applies to any and all claims, demands, causes of action, damages, losses, costs, expenses, liabilities, injuries, illnesses, death, property damage, or other harm arising out of or related to the Participant's participation in or attendance at the Activities.

PARENT/GUARDIAN EXPRESSLY UNDERSTANDS AND AGREES THAT THIS RELEASE INCLUDES CLAIMS ARISING FROM OR RELATED TO THE ORDINARY NEGLIGENCE OF WESTLAKE HOOPS OR ANY OTHER RELEASED PARTY, INCLUDING BUT NOT LIMITED TO CLAIMS RELATING TO SUPERVISION, COACHING, TRAINING, INSTRUCTION, FACILITY USE, EQUIPMENT USE, SCHEDULING, PROGRAM OPERATION, EMERGENCY RESPONSE, OR OTHER ACTS OR OMISSIONS, TO THE FULLEST EXTENT PERMITTED BY TEXAS LAW.

Nothing in this Agreement is intended to release claims that cannot legally be released under Texas law, including claims based on gross negligence, willful misconduct, or intentional misconduct, to the extent such claims may not be released as a matter of law.

This Agreement is intended to be as broad and inclusive as permitted by Texas law.

9. Indemnification and Hold Harmless

Parent/Guardian agrees to indemnify, defend, and hold harmless the Released Parties from and against any and all claims, demands, causes of action, damages, losses, liabilities, judgments, settlements, costs, and expenses, including reasonable attorney's fees, arising out of or related to:

• The Participant's participation in the Activities;
• Any injury, illness, death, or property damage involving the Participant;
• Any act, omission, misconduct, negligence, or violation of rules by the Participant, Parent/Guardian, family members, spectators, or guests;
• Any damage caused to facilities, equipment, property, or persons by the Participant, Parent/Guardian, family members, spectators, or guests;
• Any claim brought by or on behalf of the Participant, Parent/Guardian, family members, spectators, guests, or any third party relating to the Activities.

10. Transportation, Drop-Off, and Pickup

Parent/Guardian is responsible for arranging safe transportation to and from all Westlake Hoops Activities.

Unless separately agreed in writing, Westlake Hoops does not provide transportation for Participants.

Parent/Guardian understands that Westlake Hoops is not responsible for the Participant before the scheduled start time of an Activity or after the scheduled end time of an Activity, except to the extent required by law.

Parent/Guardian agrees to timely drop off and pick up the Participant and understands that repeated late pickup may result in suspension or removal from the program.

If Parent/Guardian authorizes another adult to pick up the Participant, Parent/Guardian is responsible for communicating that authorization to Westlake Hoops in advance.

11. Third-Party Events, Tournaments, and Facilities

Parent/Guardian understands that Westlake Hoops may participate in tournaments, leagues, showcases, games, or events operated by third parties.

Parent/Guardian acknowledges that third-party events may have their own rules, waivers, codes of conduct, schedules, admission fees, facility restrictions, refund policies, roster requirements, and safety protocols.

Parent/Guardian agrees that participation in third-party events may require execution of additional waivers, releases, registration forms, or agreements.

Parent/Guardian understands that Westlake Hoops does not control third-party tournament operators, referees, other teams, spectators, facility owners, facility conditions, event scheduling, parking, admissions, security, or tournament administration.

Parent/Guardian agrees that Westlake Hoops is not responsible for the acts, omissions, decisions, rules, negligence, or misconduct of third-party tournament operators, facility operators, referees, opposing teams, spectators, vendors, or other third parties.

12. Participant Conduct and Code of Conduct

Participant agrees to follow all Westlake Hoops rules, coach instructions, facility rules, tournament rules, and standards of sportsmanship. Participant shall treat coaches, teammates, opponents, referees, facility staff, parents, and spectators with respect; use appropriate language and behavior; follow instructions from coaches and authorized staff; compete with effort, focus, and sportsmanship; respect all facilities, equipment, and property; avoid bullying, harassment, threats, fighting, taunting, unsafe conduct, profanity, vandalism, theft, or disruptive behavior; and avoid using drugs, alcohol, tobacco, vaping products, weapons, or prohibited items at any Westlake Hoops Activity.

Westlake Hoops reserves the right to remove, suspend, or dismiss any Participant for unsafe conduct, disruptive behavior, rule violations, poor sportsmanship, nonpayment, or conduct that Westlake Hoops determines is inconsistent with the program's standards.

13. Parent, Guardian, and Spectator Code of Conduct

Parent/Guardian agrees that all parents, guardians, family members, and guests attending Westlake Hoops Activities shall conduct themselves respectfully and appropriately.

Parents, guardians, and spectators shall not harass, threaten, abuse, or confront coaches, referees, players, opposing teams, spectators, facility staff, or tournament personnel; interfere with coaching, instruction, games, practices, or training sessions; enter restricted areas, courts, benches, locker rooms, or team areas without permission; use profanity, engage in disruptive behavior, or act in a manner that reflects poorly on the program; violate facility rules, tournament rules, parking rules, or safety instructions; publicly criticize, embarrass, or demean Participants, coaches, referees, opposing teams, or other families; or encourage unsafe play, unsportsmanlike conduct, retaliation, or disrespect toward officials or opponents.

Westlake Hoops reserves the right to remove any parent, guardian, family member, or spectator from an Activity and may suspend or terminate the Participant's participation based on parent, guardian, or spectator conduct.

14. Facility Use, Access, and Restrictions

All Participants, parents, guardians, family members, and guests agree to comply with rules established by Westlake Hoops and by any facility owner, operator, school, church, tournament venue, or host location. Facility access may be limited to authorized areas only, including the gymnasium, designated restrooms, designated entry and exit areas, and other areas expressly approved for use.

Unless specifically authorized, classrooms, offices, kitchens, storage rooms, locker rooms, weight rooms, training rooms, stages, stairwells, courtyards, elevators, hallways outside the approved access path, and other gyms, rooms, fields, playgrounds, or facility amenities not assigned to Westlake Hoops may be off limits.

Participants, parents, guardians, and guests agree to enter and exit only through designated doors; use emergency exits only in emergencies; park only in designated areas; follow one-way traffic, parking, and pickup/drop-off instructions; keep siblings and guests supervised; avoid running, playing, or gathering in hallways, parking lots, restrooms, or restricted areas; keep food, gum, sports drinks, and non-water beverages off playing surfaces unless expressly permitted; clean up trash and personal items; and return chairs, tables, equipment, and facility items to their proper locations.

15. Facility Damage and Property Responsibility

Parent/Guardian agrees to be financially responsible for any damage caused by the Participant, Parent/Guardian, family members, or guests to any facility, property, equipment, court, restroom, hallway, parking area, furniture, fixtures, or other property used in connection with Westlake Hoops Activities.

Parent/Guardian agrees to reimburse Westlake Hoops or the applicable facility owner for repair, replacement, cleaning, or other costs resulting from such damage.

Failure to comply with facility rules or damage responsibilities may result in suspension or termination of participation privileges without refund.

16. Personal Property

Parent/Guardian understands that Westlake Hoops is not responsible for lost, stolen, damaged, or misplaced personal property, including but not limited to phones, watches, jewelry, bags, shoes, uniforms, basketballs, water bottles, clothing, equipment, or other personal items. Participants are encouraged not to bring valuables to Activities.

17. Equipment and Uniforms

Parent/Guardian understands that the Participant may be required to bring appropriate basketball shoes, athletic clothing, water, and other equipment. Parent/Guardian agrees that the Participant will not use unsafe, damaged, or inappropriate equipment. Any uniforms, jerseys, reversible jerseys, shooting shirts, or team gear provided by or purchased through Westlake Hoops may be subject to separate payment, replacement, and return policies.

18. Program Placement, Playing Time, and Team Decisions

Parent/Guardian understands that participation in Westlake Hoops does not guarantee team placement, roster selection, tournament participation, playing time, starting position, role, skill advancement, future team selection, school team selection, or any particular athletic outcome.

All decisions regarding team placement, roster composition, playing time, tournament participation, practice groups, position assignments, and player development are made by Westlake Hoops in its discretion.

Parent/Guardian understands that missed practices, conduct, effort, attendance, skill level, team needs, coachability, and other factors may affect participation opportunities.

19. Attendance, Scheduling, and Program Changes

Parent/Guardian understands that consistent attendance is important for player development and team participation.

Westlake Hoops may adjust, modify, reschedule, relocate, combine, cancel, or postpone Activities due to weather, facility availability, coach availability, low enrollment, tournament schedules, holidays, emergencies, safety concerns, or other circumstances. Westlake Hoops will make reasonable efforts to communicate schedule changes, but Parent/Guardian is responsible for monitoring communications and schedules.

20. Payments, Refunds, and Cancellations

Parent/Guardian authorizes Westlake Hoops to charge the payment method on file for applicable participation fees, including registration fees, class fees, training fees, clinic fees, camp fees, team fees, tournament fees, uniform fees, administrative fees, and other program-related charges, as applicable.

Payment for classes, clinics, camps, private training, small group training, and pay-per-session activities is due at registration or as otherwise communicated by Westlake Hoops.

Payments for team programs, tournament registrations, uniforms, travel-related expenses, or other special programs may be billed separately and are due upon acceptance, registration, roster confirmation, or other communicated deadline.

All payments are considered final once a Participant is accepted into a program, placed on a team, registered for a class, or confirmed for an event. Refunds will only be issued in the event of a documented medical condition, family relocation, or other special circumstance approved by Westlake Hoops in its sole discretion. Any approved refund may be prorated based on participation to date and non-recoverable costs already incurred, including but not limited to facility costs, coach costs, tournament fees, administrative costs, uniforms, processing fees, and third-party fees.

Processing fees, transaction fees, credit card fees, and third-party platform fees are non-refundable.

Withdrawals before the start of a program may be eligible for a partial refund or credit toward a future program, at the discretion of Westlake Hoops. Once a program has begun, no refunds or credits will be issued except in extraordinary circumstances approved by Westlake Hoops.

Westlake Hoops reserves the right to adjust, reschedule, relocate, or cancel sessions due to weather, facility availability, safety concerns, low enrollment, coach availability, or other unforeseen events. When feasible, Westlake Hoops may provide a makeup session, credit, or substitute opportunity, but no specific makeup, credit, or refund is guaranteed unless required by law.

21. Communication Consent

Parent/Guardian consents to receive communications from Westlake Hoops by email, phone, text message, app notification, registration platform, or other communication methods regarding schedules, payments, program updates, emergencies, team information, facility changes, weather updates, and other program-related matters. Parent/Guardian is responsible for keeping contact information current.

22. Media, Photography, Video, and Publicity Consent

Parent/Guardian understands that Westlake Hoops may photograph, record, film, livestream, or otherwise capture images, video, audio, name, likeness, voice, athletic performance, and participation of Participants during Westlake Hoops Activities.

The default registration option grants Westlake Hoops permission to use the Participant's name, image, likeness, voice, athletic performance, and participation for legitimate business, promotional, educational, marketing, social media, website, newsletter, advertising, archival, recruiting, team, and program purposes in any media format, without compensation.

Parent/Guardian may opt out of promotional use of the Participant's individual name, image, likeness, or voice at any time by updating their preference in the My Account area or by contacting Westlake Hoops in writing. Westlake Hoops will make reasonable efforts to honor this request, but incidental background appearances in group photos, videos, livestreams, public tournament settings, or third-party media may still occur and may not be fully controlled by Westlake Hoops.

Parent/Guardian waives any right to inspect or approve the finished product and releases Westlake Hoops from claims related to the authorized use of such materials, including claims based on privacy, publicity, defamation, or misappropriation, to the fullest extent permitted by law.

Revocation of media consent will apply only to future uses after receipt and processing of the written notice and will not require removal of materials already published, distributed, printed, posted, or used.

23. Background Checks, Safety, and Reporting

Westlake Hoops may require coaches, employees, contractors, or volunteers to complete background checks, training, or safety requirements as determined by Westlake Hoops or applicable facilities, leagues, or tournament operators. Parent/Guardian understands that no safety protocol can eliminate all risks associated with youth sports participation.

Parent/Guardian agrees to immediately report any safety concern, inappropriate conduct, injury, suspected abuse, harassment, bullying, or misconduct to Westlake Hoops leadership. Westlake Hoops may take action it deems appropriate in response to safety concerns, including removing a Participant, coach, parent, spectator, or other individual from Activities.

24. Illness, Communicable Disease, and Health Protocols

Parent/Guardian agrees that the Participant will not attend Activities if the Participant has a fever, contagious illness, vomiting, diarrhea, unexplained rash, symptoms of a communicable disease, or has been advised by a healthcare provider or school to avoid participation.

Parent/Guardian understands that participation may involve exposure to illnesses, viruses, bacteria, and communicable diseases. Westlake Hoops may implement health, hygiene, illness, or safety protocols and may remove or restrict participation if a health or safety concern exists.

25. No Guarantee of Safety or Results

Parent/Guardian understands that Westlake Hoops cannot guarantee that injuries, illnesses, accidents, losses, or other adverse events will not occur. Parent/Guardian also understands that Westlake Hoops does not guarantee specific athletic improvement, team placement, playing time, tournament results, school team selection, recruiting outcomes, scholarship opportunities, or other performance outcomes.

26. Acknowledgment of Rules and Policies

Parent/Guardian and Participant agree to comply with all Westlake Hoops rules, policies, codes of conduct, payment policies, team rules, facility rules, tournament rules, and coach instructions, whether written or communicated verbally. Westlake Hoops may update its rules and policies from time to time. Continued participation after notice of updated rules or policies constitutes acceptance of those rules and policies.

27. Termination of Participation

Westlake Hoops reserves the right to suspend, restrict, or terminate participation at any time for reasons including but not limited to unsafe conduct, disruptive behavior, violation of rules or policies, parent, guardian, spectator, or Participant misconduct, nonpayment, repeated absences, facility rule violations, damage to property, or conduct inconsistent with Westlake Hoops values or program standards. Termination or suspension for conduct, rule violations, or nonpayment does not entitle Parent/Guardian to a refund.

28. Governing Law, Venue, and Texas Law Application

This Agreement shall be governed by and construed in accordance with the laws of the State of Texas, without regard to conflict-of-law principles. Any dispute arising out of or relating to this Agreement, the Participant's participation, or Westlake Hoops Activities shall be brought exclusively in the state or federal courts located in Travis County, Texas, unless otherwise required by law.

This Agreement is intended to satisfy applicable Texas requirements for enforceable releases and waivers, including fair notice, conspicuousness, and express reference to negligence, to the fullest extent permitted by Texas law. If any portion of this Agreement is found to be invalid, unenforceable, or unlawful, the remaining portions shall remain in full force and effect.

29. Entire Agreement

This Agreement, together with the Westlake Hoops Terms & Conditions, constitutes the entire agreement between Parent/Guardian and Westlake Hoops regarding the Participant's participation in Westlake Hoops Activities and supersedes all prior or contemporaneous oral or written statements, discussions, representations, or agreements regarding the same subject matter.

No oral statement shall modify this Agreement. Any modification must be in writing and signed by Westlake Hoops.

30. Electronic Acknowledgment

By checking the acknowledgment box on any Westlake Hoops registration, interest, or membership form, Parent/Guardian agrees that they:

• Have read this entire Agreement;
• Understand its terms;
• Understand that they are giving up certain legal rights;
• Understand that this Agreement includes a release of claims arising from ordinary negligence to the fullest extent permitted by Texas law;
• Are checking the box voluntarily;
• Have had the opportunity to ask questions before submitting;
• Are the parent or legal guardian of the Participant;
• Agree that this Agreement is binding upon them, the Participant, and their heirs, executors, administrators, successors, and assigns;
• Intend this Agreement to be a legally binding release, waiver, assumption of risk, indemnity, medical authorization, and participation agreement to the fullest extent permitted by Texas law.

Westlake Hoops records the date, time, version of this Agreement, and the email address used to acknowledge it for each submission.

Participant Information & Emergency Contacts

Parent/Guardian agrees to provide and keep current the following information for each Participant. This information can be added or updated at any time from the My Account area after signing in:

• Participant name, date of birth, grade, and school;
• Known allergies, medical conditions or restrictions, prior injuries or concussion history, and current medications;
• Physician name and phone, health insurance provider, and policy/member number;
• Medical disclosure checkboxes (asthma, severe allergy/EpiPen, prior concussion, heart condition, seizure condition, diabetes, bone/joint/ligament/muscle injury, medication required during Activities, behavioral/emotional/developmental considerations, other) with explanation as needed;
• Parent/Guardian name, phone, email, and address;
• Two emergency contacts (name, relationship, phone);
• Authorized pickup persons.

Parent/Guardian acknowledges that failure to disclose relevant medical information may increase the risk of injury or illness during participation.