Medical & Liability Release

I, ________________________, am the parent/legal guardian of ___________________. I agree to completely release from liability and to hold harmless the Tacoma Tide Sports Club, its coaches, officers and volunteers in connection with the 2010 spring 3v3 basketball season for an injury or damage which may be suffered by the participant arising out of or in any way connected with playing in the 3v3 basketball league.   Furthermore, I understand that photographs and/or video taken during 3v3 events may be used by the Tacoma Tide Sports Club for promoting our programs, events, in print, or on our website.

Emergency Medical Release

I grant permission to the Tacoma Tide Sports Club to seek emergency medical treatment in case of any injury sustained while participating in the 2010 spring 3v3 basketball league.

_____________________________________  ____________ _____________________

(Parent/Legal Guardian signature)                      (Date)              (Contact phone #)

Hospital Preference________________________________________________________

Doctor’s Name / Office _______________________________ Phone: _______________

Medical Insurance Company_______________________ ID #_____________________

Alternate Emergency Contact__________________________ Phone: _______________

Player Medical Information:

Allergies or other medical conditions:  ________________________________________

Is this player Asthmatic? _________Severity of Asthma___________________________

Additional Comments or Concerns: ________________________________________________________________________________________________________________________________________________________________________________________________________________________