KC Premiere Required Waiver Forms For Participants AND Attendees

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The form begins here. The required names / signature(s) fields follow.

*Note that you can move from field to field by using your "tab" key.

Player's TEAM Name *

"LAST" Name Only of Coach *

Team Grade Level & Gender *

Providing FIRST and LAST names below act as an electronic signature(s), and is legal acknowledgement that all parties 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 anyone included in this waiver is 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.

Player's FIRST Name *

Player's LAST Name *

Following, by providing the electronic signature of "Parent / Guardian #1," you are signing off in behalf of the player and anyone else, including those under the age of 18, whose name you provide on this acknowledgment form.

Parent / Guardian #1 FIRST and LAST Name *

Parent / Guardian # 1 PHONE # (include area code) *

FIRST and LAST Names must be provided for ALL OTHERS in your immediate family (INCLUDING children ages 5 - 18) who plan on attending Kansas City Premiere Basketball League and or Tournament Games. FOLLOWING, by providing names, acknowledges that those attending have read and understand the criteria provided in BOTH waivers. Providing FIRST and LAST Names act as legal signatures upon submitting this form.Upon arrival at the game location, ALL persons entering the venue will be cross-checked with our database of those who have successfully completed and submitted this form. Once verified, admittance will be allowed.

Parent / Guardian #2 FIRST and LAST Name

Parent / Guardian #2 PHONE # (include area code)

Family Member #1 FIRST and LAST Name

Family Member #2 FIRST and LAST Name

Family Member #3 FIRST and LAST Name

Family Member #4 FIRST and LAST Name

After submitting, upon checking in at the gym, you will receive an online "waiver receipt," good for one year.

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