Online Waiver | Next Level Hoops

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Next Level Hoops Liability Waiver

Participant First Name

Email

Do you know of any reasons why you should not engage in physical activity? *

No

Yes

Participant Last Name

Participant Date of Birth

Is the participant Under the age of 18? *

No

Yes

Please specify anything we should know about

Initials

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Thanks for submitting!

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