Assumption of Risk/Liability Release

I hereby authorize the staff of Team Ichiban Basketball Club/Episcopal High School/Bellaire High School/St. Piux High School to act for me, according to their best judgment, in any emergency requiring medical attention during the “Team Ichiban Club” spring/summer tournament season, and hereby waive and release the directors/workers or anyone associated with Team Ichiban Basketball Club/Episcopal High School/Bellaire High School/St. Piux High School from any liability for any injuries or illnesses incurred while at any Team Ichiban Basketball Club event.

          I have no knowledge of any medical problem or physical impairment that would be affected by participation. Team Ichiban Basketball Club/Episcopal High School/Bellaire High School/St. Piux High School or the nearest medical facility is hereby authorized to render primary care.  Assumption of Risk/Release from Liability

          It is further understood that Team Ichiban Basketball Club/Episcopal High School/Bellaire High School/St. Piux High School does not provide medical insurance covering injuries of any nature incurred at any Team Ichiban Basketball Club function. The undersigned hereby releases Eugene Watts, Team Ichiban Basketball Club, Episcopal High School, Bellaire High School, St. Piux High School its successors, assigns, officers, agents, and employees, from any and all claims, demands, and causes of action whatsoever in any way growing out of or resulting from participation in Team Ichiban Basketball Club functions.

Participant’s Name:

Participant Signature:

Participant Parents/Guardian’s

Signature:

Date: