Coach, Ref & Event Staff Waiver Form
The form begins here. The required name / signature fields follow.

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Your Title *
Providing FIRST and LAST names below act as an electronic signature, and is legal acknowledgement that you have read and understand the details provided in the preceding waivers -- "K.C. Premiere Basketball / Premiere Basketball Inc. Waiver," and the "Parkville Athletic Complex 2020 Return To Play Waiver" and also, in the event that you are exposed to an individual with COVID-19, you consent to KC Premiere Basketball providing your contact information to the local health department for the purpose of confidential contact tracing to help slow the spread of COVID-19 throughout our community.
TEAM NAME if Coach
FIRST Name *
LAST Name *
Phone # (Include Area Code) *
After submitting, upon checking in at the gym, you will receive an online "waiver receipt," good for one year.
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