Youth Basket Ball Registration & Waiver
Event Timing: Starting Friday Sep 27, 2019 | 6-8 PM
Event Address: 6770 Edenwood Middle School, Mississauga
Contact us at info@mici.org
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Parent Name *
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Emergency Contact Name & Number *
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Waiver and Release of Liability: This is a binding legal agreement and as a participant or a representative to the participant in the programs and / or activities of the Meadowvale Islamic Centre Inc. (MIC), I acknowledge the undersigned and agree to the following terms. The Organization, defined by the Meadowvale Islamic Centre Inc, directors, officers, members, employees, coaches, volunteers, officials, participants, sponsors, owners/operators, and representatives of the Centre are not responsible for any injury, damage, or loss of any kind suffered by a participant during, or as a result of, any program, activity or event within or outside the Centre premises, caused in any manner whatsoever including, but not limited to, the negligence of the Centre. I hereby acknowledge that I am aware of the risks and hazards associated with or related to this activity. The risks and hazards include, but are not limited to:• Injuries from executing strenuous and demanding physical techniques in basketball, soccer, football or any other sport;• Injuries from grass, turf and other surfaces including bacterial infections and rashes;• Injuries resulting from falls to the ground due to uneven or irregular terrain or surfaces;• Injuries from collisions with walls and/or any sport equipment;• Injuries resulting from failure to properly use any piece of equipment or the mechanical failure of the equipment;• Spinal cord injuries which may render me permanently paralyzed;• Injuries from extreme weather conditions which may result in heatstroke, sunstroke or hypothermia;• Injuries from contact, colliding or being struck by other participants, spectators, equipment or vehicles;• Injuries resulting from vigorous physical exertion and strenuous cardiovascular workouts;• Travel to and from competitive events and associated non-competitive events which are an integral part of the organization’s activities.• Injuries sustained in basketball, soccer, football or any other sport can be severe;• Participant may experience anxiety while challenging oneself during the activities;• Participant may come into close contact with others, including the possibility of accidental and unexpected contact;• Risk of injury is reduced if participant follow all rules established; and • Risk of injury increases as participant becomes fatigued. By participating voluntarily in these events, I am exposed to these risks and hazards. I agree to accept them and be responsible for any injury or other loss which I might receive while participating in these events, activities and programs. If something happens to me or my child, I release the organizers of responsibility for any claims, demands, actions and costs which might arise out of my participation. In this agreement I understand “organization” as mentioned earlier. I have read and understood the terms and conditions of this agreement, and by signing it voluntarily, I am agreeing to abide by these terms. I will also ensure that my child is wearing the right protective gear when playing or sitting on the sideline.I will follow the rules & regulations put-forth by the organizers and I understand that these may change from time to time. That this is a Boys only Basketball Free program & requires Registration. Rules may apply to follow the Islamic Etiquettes and Obligations & all participants will need to adhere. *
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I have read and understood the above terms and conditions of this agreement, and by signing it voluntarily, I am agreeing to abide by these *
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Participant Name (Signature) *
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Parent / Guardian Name (Signature)
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Meadowvale Islamic Centre, Inc. 6508 Winston Churchill, Mississauga, ON L5N 3W4. (905)824-2604 http://www.mici.org info@mici.org
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