3 on 3 HOOPS TOURNAMENT - ADULT

PRESENTED BY THE ROYCE BROWNING ALS FOUNDATION
August 16th (Sunday Only)
18 yrs & up

Team Name *
Contact Person * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone * - ### - ### ####
Email *
I understand/agree: *
By submitting this form, I hereby authorize the staff of Hardwood Palace to act for me according to their best judgement in any emergency requiring medical attention, and I hereby waive and release Hardwood Palace from any and all liability for any injuries incurred while on the facility property. I have no knowledge of any physical impairment that would be affected by my participation in the Hardwood Palace program. I also understand that Hardwood Palace retains the right to use for publicity and/or advertising purposes any photographs of any participants taken at Hardwood Palace events.
Player # 1: * First Last
Player # 2: * First Last
Player # 3: * First Last
Player # 4: First Last
Player # 5: First Last