West Hempstead Basketball League

In association with the Hillcrest Softball League and Hillcrest Football League

Individual Waiver and Release of Liability

In consideration of being allowed to participate in any way in the West Hempstead Basketball League and related events and activities, the undersigned :

1. Acknowledges and fully understands that he/she the participant will be engaging in activities that will involve risk of serious injury, including permanent disability and death, and severe social economic losses which might result not only from the participants own action, inactions or negligence, inactions or negligence of others, the rules of play, or the conditions of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.

2. Agrees to inspect the facilities and equipment to be used prior to participation and if he believes anything is unsafe, I will immediately advise his coach, captain, supervisor, umpire or referee of such condition(s) and refuse to participate.

3. Assumes all the foregoing risks and accepts personal responsibility for the damages following such injury, permanent disability or death.

4. Is in good physical condition, and has been cleared by a practicing medical physician to play basketball in the West Hempstead Basketball League for the season, and has been cleared to engage in any physical activity associated with the West Hempstead Basketball League, and to play any basketball or other physical sporting games.

5. Is aware and acknowledges that the West Hempstead Basketball League, Ariel Cohen and/or Ari Herskovits may not have access on premises to a defibrillator, or other medical equipment or first aid.

6. Agrees to bring necessary beverages and/or food to each game, as needed.

7. Agrees to properly hydrate one’s self prior to and during a game.

8. Agrees to bring any and all necessary medical equipment, including emergency first aid equipment to each game. This includes any preventative medical equipment, or any post-injury medical equipment.

9. Agrees to abide by all rules, procedures and bylaws of the West Hempstead Basketball League, including to pay all fines, league fees, and to abide by all disciplinary judgements of the league commissioners/administrators.

10. Understands that all league fees for the entire season must be paid in full in advance of playing in any games. Furthermore, all league fess are not subject to refund for any reason, including but not limited to injury, discrimination, cancelled games, the nature of the other players in the league or on the same team, the equipment provided or to the nature of any referees or scorers officiating in the league.

11. Releases, waives and discharges his/her right to sue Ariel Cohen for any reason related to this sporting league, or related to any sports or sporting league. Releases, waives and discharges Ariel Cohen from any and all liability.

12. Releases, waives and discharges his/her right to sue the West Hempstead Basketball League and any of it’s administrators, directors, agents, coaches, captains, umpires, referees and other employees of the organization, it’s President, Ariel Cohen, it’s Commissioner, Ari Herskovits, other participants, sponsoring agencies, sponsors, advertisers, any affiliated clubs, and if applicable, owners and lessors of premises used to conduct the event, all of which are hereinafter referred to as “releasees,” from any and all liability to each of the undersigned, his or her heirs and the next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

I have read, understand and will comply with all of the rules above and all of the rules of the West Hempstead Basketball League. In consideration of my signing this statement, I hereby, for myself, my heirs and administrators, assume any and all risks, which might be associated with my participation in the West Hempstead Basketball League. I agree to release, hold harmless and indemnify the West Hempstead Basketball League and it’s directors, officers, employees, agents, it’s President, Ariel Cohen, it’s Commissioner, Ari Herskovits and assign from all claims, liabilities, losses, damages and expenses, including, without limitation, all attorneys’ fees, which I may suffer as a result, arising out of, or in connection with any event or activity of the West Hempstead Basketball League equipment. I agree to all the terms and conditions of this document.

Name: ______________________________________ Phone: ______________________

Address: ______________________________________________________________________

E-mail: _______________________________________________________________________

Signature: ____________________________________ Date: _______________________