REGISTER BELOW FOr:
MLK DAY CAMP &
PRESIDENTS DAY CAMP!
@ OUR LADY OF GRACE GYM
310 KANE BLVD. Pittsburgh PA 15243
For BOYS AND GIRLS
MLK DAY CAMP - Monday January 17th
Grades 3-5 CANCELLED
Grades 6-8 1:30Pm-4:00pm
Presidents Day Camp - Monday February 21st
Grades 3-5 9:o0am-11:30Am
Grades 6-8 11:30Am-2:00pm
Limiting 30 Players Per Group
Cost of Camp is $85 Each
or $125 For Both and Save!!
Camp will consist of:
Skills & Drills - Live Play -Contests & Competitions
Learning & Concepts - EXPERT COACHING
*Payment will be accepted
on the first day of camp via cash or check
Credit Card Invoices Can also be sent Upon Request($20 Surcharge)
FILL OUT REGISTRATION FORM BELOW FIRST
THIS FORM ACTS AS BOTH REGISTRATION AND WAIVERS
PLEASE READ THE WAIVERS CAREFULLY BEFORE SUBMITTING
***I am submitting this form as both a registration and waiver for my child. I understand that by submitting this form, I am agreeing to the waiver information listed on this page. I also confirm that I am 18 years of age, or the parent/guardian of the player (Player Name) listed above. I ALSO CONFIRM THAT I HAVE READ THE COVID-19 WAIVER FORM, AND ALSO CONSENT TO THAT WAIVER, UPON ELECTRONIC SUBMISSION OF THIS REGISTRATION FORM.
Please read any waiver carefully. It includes a release of liability and waiver of legal rights and deprives you of the ability to sue certain parties. Do not agree to this document unless you have read and understood it in its entirety. By agreeing electronically, you acknowledge that you have both read and understood the text presented to you as part of the registration process. You also understand and agree that events carry certain inherent dangers and risks which may or may not be readily foreseeable, including without limitation personal injury, property damage or death. Your ability to participate in the event(s) is/are subject to your agreement to the waiver and by agreeing herein, you accept and agree to the terms of the waiver and release agreement.
I ALSO UNDERSTAND THAT THERE ARE NO REFUNDS!
MAXIMUM HOOPS WAIVER FORM
I understand that I am enrolling my child in the Maximum Hoops LLC or affiliated program, and that Coach Steve Brodzinski, Maximum Hoops LLC, or any coaches or facilities used, will not be liable for any injuries incurred during participation in the program. I understand that there is a significant risk of injury during any basketball related activity. I also understand that there are NO REFUNDS. I give full permission to use my child's image and likeness in any media, including photos and video.
By enrolling in a Maximum Hoops LLC event, participant understands that he/she attending the event does so at his/her own risk. Maximum Hoops LLC, Steve Brodzinski, employees or agents, shall not be liable for any damage whatsoever arising from any personal injury or property loss sustained by participant with his/her family in or about any programs on the premises. Participants and parents assume full responsibility for all injuries and damages which occur in or about any programs on the premises, He/She does hereby fully and forever release discharged hold harmless Maximum Hoops LLC, Steve Brodzinski, all associated facilities and its owner, employees, coaches, and agents from any and all claims, demands, damages or rights of action, present or future resulting from any person’s
participation in any programs or use of the facility.
In addition, he/she agree(s) to follow the rules of conduct and play set by Maximum Hoops LLC, Steve Brodzinski, or any coaches or agents. Failure to do so may result in suspension from participation.
I hereby authorize Maximum Hoops LLC, Steve Brodzinski, and it’s representatives to act for me according to his/her best judgment in an emergency requiring medical attention. I know of no such medical or physical problems that might affect my child’s ability to safely participate in any Maximum Hoops LLC event. I will be responsible for all medical charges, along with any other charges, in connection with his/her attendance of this activity. I agree to abide by the rules and regulations set by Maximum Hoops LLC, Steve Brodzinski., and any involved coaches or agents.
1. Authority to Register and/or to Act as Agent. You represent and warrant to Maximum Hoops LLC, Steve Brodzinski and any affiliated party, that you have full legal authority to complete this event registration on behalf of yourself and/or any party you are registering (the "Registered Parties"). As used in this Agreement and Waiver, Maximum Hoops LLC, Steve Brodzinski refers to itself, and any and all subsidiaries, affiliated entities, or entities that control or are controlled by Maximum Hoops LLC or Steve Brodzinski singly or together and its officers, employees, contractors, subcontractors and agents. If you are registering a child under the age of 18 or an incapacitated adult you represent and warrant that you are the parent or legal guardian of that party and have the legal authority to enter into this agreement on their behalf and by proceeding with this event registration, you agree that the terms of this Agreement and Waiver shall apply equally to all Registered Parties. By registering a child under 18, you agree and consent to the collection of that child's information which you provide for the purposes of registration.
2. Waiver.YOU UNDERSTAND THAT PARTICIPATION IN ANY Maximum Hoops LLC EVENT IS POTENTIALLY HAZARDOUS, AND THAT A REGISTERED PARTY SHOULD NOT PARTICIPATE UNLESS THEY ARE MEDICALLY ABLE AND PROPERLY TRAINED. YOU UNDERSTAND THAT EVENTS MAY BE HELD OVER PUBLIC ROADS AND FACILITIES OPEN TO THE PUBLIC DURING THE EVENT AND UPON WHICH HAZARDS ARE TO BE EXPECTED. PARTICIPATION CARRIES WITH IT CERTAIN INHERENT RISKS THAT CANNOT BE ELIMINATED COMPLETELY RANGING FROM MINOR INJURIES TO CATASTROPHIC INJURIES INCLUDING DEATH.
YOU UNDERSTAND AND AGREE THAT IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE EVENT, YOU AND ANY REGISTERED PARTY, THE HEIRS, PERSONAL REPRESENTATIVES OR ASSIGNS OF YOU OR THE REGISTERED PARTY DO HEREBY RELEASE, WAIVE, DISCHARGE AND CONVENANT NOT TO SUE Maximum Hoops LLC nor Steve Brodzinski FOR ANY AND ALL LIABILITY FROM ANY AND ALL CLAIMS ARISING FROM PARTICIPATION IN THE Maximum Hoops LLC EVENT BY YOU OR ANY REGISTERED PARTY.
3. Limitation of Liability; Disclaimer of Warranties. Maximum Hoops LLC, nor Steve Brodzinski SHALL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES, RESULTING FROM (A) THE USE OR THE INABILITY TO USE Maximum Hoops LLC OR (B) FOR THE COST OF PROCUREMENT OF SUBSTITUTE GOODS AND SERVICES OR (C) RESULTING FROM ANY GOODS OR SERVICES PURCHASED OR OBTAINED OR TRANSACTIONS ENTERED INTO THROUGH Maximum Hoops LLC OR (D) RESULTING FROM UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR DATA, INCLUDING BUT NOT LIMITED TO, DAMAGES FOR LOSS OF PROFITS, USE, DATA OR OTHER INTANGIBLE, EVEN IF Maximum Hoops LLC HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. YOU EXPRESSLY AGREE THAT USE OF Maximum Hoops LLC IS AT YOUR SOLE RISK. Maximum Hoops LLC IS PROVIDED ON AN AS IS AND AS AVAILABLE BASIS. Maximum Hoops LLC EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION ANY WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT.
4. Indemnification. You agree to indemnify and hold Maximum Hoops LLC, Steve Brodzinski and employees, volunteers, or affiliated parties harmless from and against any and all damages, costs, claims or demands, including reasonable attorneys' fees, made by any third party due to or arising from or relating to your use Maximum Hoops LLC's basketball training, or the violation of any term of this Agreement and Waiver.
5. Severability. You further expressly agree that this Agreement and Waiver is intended to be as broad and inclusive as is permitted by the law and that if any provision of this Agreement and Waiver shall be found to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and Waiver and shall not affect the validity and enforceability of any remaining provisions.
BY INDICATING YOUR ACCEPTANCE OF THIS AGREEEMENT AND WAIVER, YOU ARE AFFIRMING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT AND WAIVER AND FULLY UNDERSTAND ITS TERMS. YOU UNDERSTAND THAT YOU ARE GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE.
YOU ACKNOWLEDGE THAT YOU ARE SIGNING THE AGREEMENT AND WAIVER FREELY AND VOLUNTARILY, AND INTEND BY YOUR ACCEPTANCE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
You must be over 18 years of age OR the parent/legal guardian of a minor under 18 years of age OR the legal guardian of an incapacitated and/or mentally challenged person in order to agree to the text above.
MAXIMUM HOOPS LLC PLAYER CONSENT FORM Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. MAXIMUM HOOPS LLC has put in place preventative measures to reduce the spread of COVID-19; however, MAXIMUM HOOPS LLC cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending MAXIMUM HOOPS LLC events could increase your risk and your child(ren)’s risk of contracting COVID-19. I confirm that I am not presenting any of the following symptoms of COVID-19 listed here: Fever, Shortness of Breath, Loss of Sense of Taste or Smell, Dry Cough, Runny Nose, Sore Throat. I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending this event and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at MAXIMUM HOOPS LLC events may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or 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 child(ren)’s attendance at the event (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless MAXIMUM HOOPS LLC, Stephen Brodzinski, 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 MAXIMUM HOOPS LLC, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any event or program.