WEE BASKETBALL | FALL 2024 DETAILS: A 6 week basketball clinic for boys and girls ages 3-7, focused on developing and honing fundamental skills. Bring your own water and soccer ball (write your name on it).FOR AGES: 3-7 year oldDATES/TIMES: Oct 15th, 22nd, 29th, Nov 5th, 12th, 19thSession 1: 4:15 – 5 pm **CLOSED** Session 2: 5:15 – 6 pm LOCATION: First Christian Church Family Life Center, 2306 13th Street, LBK, TXCOST: $110 per athlete Registration Form Event Location Dates Please Select Your session Session 2: 5:15 - 6 pm Session 2: 5:15 - 6 pm Athletes Name Age Athlete's Dominant Hand Right Left Birthdate Gender Boy Girl Parent/Guardian Name Parent/Guardian Cell Number Parent/GuardianEmail Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe Is the athlete prescribed an inhaler? If yes, please explain any instructions. How did you hear about us? Informed Consent and Acknowledgement: I hereby give my approval for my child’s participation in any and all activities prepared by Lubbock Wee Sports during the selected clinic/camp. In exchange for the acceptance of said child’s candidacy by Lubbock Wee Sports ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Lubbock Wee Sports, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected clinic/camp sessions. In case of injury to said child, I hereby waive all claims against Lubbock Wee Sports, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball, soccer and track. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death. I give permission to Lubbock Wee Sports and its related and affiliated entities, officers/directors, employees, and agents to take video and photographic images, or other reproductions or likenesses in any media form (collectively "Images") of my participating child and their participation in the programs and activities. I consent to and authorize and license Lubbock Wee Sports to use these images on Lubbock Wee Sports social media, website and any marketing or promotional materials, and in any other lawful uses in any medium. I agree that all images are and shall remain the property of Lubbock Wee Sports. Medical Release and Authorization: As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Lubbock Wee Sports, and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence. First Christian Church of Lubbock, TX WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT 1. In consideration for receiving permission to participate in youth athletic activities in the First Christian Church Family Life Center, sponsored and conducted by First Christian or other outside group using the facility, I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE First Christian Church of Lubbock, Texas, its individual officers, leadership groups, agents, members, or employees (hereinafter referred to collectively as FCC) from any and all liability, claims, demands, action and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my child, or to any property belonging to me, WHETHER CAUSED BY THE NEGLIGENCE OF FCC, or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted. 2. I hereby elect to voluntarily participate in said activity, and to enter the above-named premises and engage in such activity knowing that a certain risk of harm may be inherent in the various activities contemplated herein. 3. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS FCC from any loss, liability, damage or costs, including court cost and attorney's fees, that they may incur due to my and my child’s participation in said activity, WHETHER CAUSED BY OR CONTRIBUTED TO IN WHOLE OR PART by any action or failure to act, negligence, breach of contract, or other misconduct on the part of FCC or otherwise. 4. It is my express intent that this Release and Hold Harmless Agreement shall bind all members of me, my family and spouse, including my participating child, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE FCC. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Texas. 5. I also understand that the property on which the activity is occurring is a part of and owned by First Christian Church of Lubbock, TX. I and my family acknowledge the Statement of Faith of First Christian Church that follows: “As members of the Christian Church, we confess that Jesus is the Christ, the Son of the Living God, and proclaim Him Lord and Savior of the world. In Jesus Christ’s name and by His grace we accept our mission of witness and service to all people. We rejoice in God, Maker of heaven and earth, and in the covenant of love which binds us to God and one another. Through faith in Jesus Christ, we are baptized into His death and are clothed with Christ, making us one with the whole people of God. In the communion of the Holy Spirit, we are joined together in discipleship and obedience to Jesus Christ. At the table of the Lord, we celebrate with thanksgiving the saving acts and presence of Jesus Christ. Within the whole church we receive the gift of ministry and the light of Scripture. We take the Bible to be the sole guide for Christian faith and practice. In the bonds of Christian faith, we yield ourselves to God that we may serve the One whose kingdom has no end. Blessing, glory, and honor be to God forever. Amen.” BY SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability and Hold Harmless Agreement and Faith Statement, understand it, and sign it voluntarily as my own free act and deed. No oral representations, statements, or inducements, apart from the foregoing written agreement, have been made. I am at least eighteen (18) years of age and fully competent, and I execute the Release for full, adequate, and complete consideration fully intending to be bound by same. Submit