Player Name *

First Name

Last Name

Player D.O.B. *

MM

DD

YYYY

Parent Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Checkbox *

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my attendance or participation in BR & Sportfriends SC programming (“Claims”). I hereby release, covenant not to sue, discharge, and hold harmless Black River Athletics, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the company, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Black River program. Additionally, I hereby grant Black River Athletics and their agents permission to use photographic portraits, pictures, digital images or videotapes of my child, or in which my child may be included in whole or part, or reproductions thereof in color or otherwise for any lawful purpose whatsoever, including but not limited to use in any company publication or on the company website, without payment, approval or any other consideration.

By checking this box I acknowledge and accept the statement above