JOEL ANTHONY BASKETBALL CLINIC

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JOEL ANTHONY BASKETBALL CLINIC Friday, August 7,
2009 PARTICIPANT REGISTRATION FORM
JOEL ANTHONY BASKETBALL CLINIC WAIVER AND
RELEASE OF LIABILITY In considering of the
individual whose name is set forth above (the
Participant) being permitted by NBA Canada
(NBAC) and Canada Basketball (CB) to
participate in the Joel Anthony Basketball
Clinic and related events and activities,
Participant and if Participant is under the age
of majority in the province in which Participant
resides, I, the parent or legal guardian of the
Participant, on behalf of Participant, hereby
1. (a) acknowledges that Participants
participation in the Joel Anthony Basketball
Clinic involves risk of injuries, property damage
and/or other harm which might result not only
from the Participants actions, inactions, or
negligence, but also from the actions, inactions
or negligence of others, the conditions of the
premises or of any equipment used, and that there
may be other risks not known or reasonably
foreseeable at the time and (b) accepts sole
responsibility for all of the hazards and risks
to Participant and Participants property
associated with or related to Participants
participation in the Joel Anthony Basketball
Clinic and for any damage or injury that
Participant may cause to others 2. Releases,
waives and forever discharges any and all claims
of damages or causes of action, including but not
limited to personal injury or loss of damage to
property, which Participant or any of
Participants representatives, heirs, next of kin
or assignees (Participants Representatives)
may have or which may hereinafter accrue to
Participant or Participants Representatives as a
result of Participants participation in the Joel
Anthony Basketball Clinic or otherwise and which
may be asserted by Participant, or Participants
Representatives against NBA Canada and/or Canada
Basketball and their respective officers,
directors, governors, owners and affiliates 3.
Agrees to indemnify and save and hold harmless
the Released Entities and each of them from loss,
liability, damage or cost they may incur due to
the undersigneds participation in the Joel
Anthony Basketball Clinic, whether causes by the
negligence of the Released Entities or otherwise
4. Grants permission to the Released Entities to
collect and utilize the personal information of
Participant provided above to administer and
conduct the Joel Anthony Basketball Clinic and to
collect and use Participants name, voice,
statements, photograph, image, likeness, actions
at the Clinic and/or Participants biographical
data in any live or recorded form, in whole or in
part, for promotional, commercial or any other
purpose, in perpetuity worldwide on standard and
non-standard television, home video, print,
electronic and on-line media (including, without
limitation, the Internet), and in any other means
of distribution, publication or exhibition,
whether now known or hereinafter create without
any additional consideration in connection with
the Joel Anthony Basketball Clinic, future
programs, and the marketing, advertising and
promotion thereof. FOR PARTICIPANTS OF
MINORITY AGE (UNDER AGE 18 AT TIME OF
REGISTRATION) This is to certify that I, as
parent/guardian with legal responsibility for
this participant, do consent and agree to his/her
release as provided above of all Releases, and,
for myself, my heirs, assigns and next of kin, I
have read this waiver and release of liability,
fully understand its terms and agrees to
indemnify the Releases from any and all
liabilities to my minor childs involvement or
participation in the program as provided
above.
Please fax completed registration form to
Kelly Woloshyn at [phone]