Medical & Parent Consent
I consent to and assume all risks and hazards of and incidental to the participation of the above named boy or girl in the activities of Impact Hoops Basketball and agree to indemnify the said Association and its officers, servants, or agents nominated or appointed by or on its behalf against all loss from any claim here after made against it, them or any of them by or on behalf of the said boy or girl and arising directly or indirectly from such participation. I also understand that it is my responsibility to keep the Impact Hoops staff advised of any change in their medical condition as soon as possible and that in the event no one can be contacted, Impact Hoops staff will admit my child to the hospital if deemed necessary. I hereby authorize personnel of the Impact Hoops to authorize appropriate emergency medical services as determined by the physician, and agree to abide by the consent and indemnity agreement stated above.
** Payment must be completed online.
Jon Schmidt
778 808 5170
[email protected]
