I hereby agree, in return for becoming a member of the LaSALLE Guardians Basketball training sessions, league & travel team:

• TO RELEASE THE LaSALLE GUARDIANS BASKETBALL, event organization bodies, sanctioning bodies and LaSALLE GUARDIANS BASKETBALL sponsors and their respective directors, officers, employees, agents, volunteers, contractors, representatives, successors or assigns (collectively the “Releasees”) from any liability for any loss, damage, injury or expense (collectively “Loss”) that I may suffer as a result of my participation in and transportation to or from any LaSALLE GUARDIANS BASKETBALL program, due to any cause, including negligence or breach of contract;
  
  
• TO WAIVE ANY CLAIM that I have or may have against any or all of the Releasees regarding any matter, including without limitation, any claim arising out of any LaSALLE GUARDIANS BASKETBALL program;
  
  
• TO INDEMNIFY THE RELEASEES from any and all claims, actions or Loss resulting in any way from my participation or participation of the child named below in any LaSALLE GUARDIANS BASKETBALL program;
  
  
• THIS DOCUMENT SHALL bind my heirs, executors, administrators, assigns and representatives and will have effect throughout my membership in the LaSALLE GUARDIANS BASKETBALL and, to the extent reasonably necessary to give it effect, thereafter;
  
  
• THAT I am (or the child named below is) physically fit to participate in any LaSALLE GUARDIANS BASKETBALL programs; I am a legal guardian or custodial parent of the child named below.
  
  
• THAT the LaSALLE GUARDIANS BASKETBALL is authorized to take photos of the child named below or me at its programs for publicity and promotional purposes only.
  
  
• I hereby acknowledge and agree that LaSALLE GUARDIANS BASKETBALL may use and disclose the information on this form to enable LaSALLE GUARDIANS BASKETBALL to provide membership benefits to all LaSALLE GUARDIANS BASKETBALL members.
  
  
• I HAVE READ AND UNDERSTAND THIS AGREEMENT. By submitting this application, I acknowledge having read, understood and agree to the above Waiver, Release and Indemnity and further agree to conduct myself in accordance with the ‘Guidelines for Behavior’ at LaSALLE GUARDIANS BASKETBALL Sanctioned Events, as set out on the reverse of this form.