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Step 1:

Athlete's Name *
Athlete's Name
Changing The Culture, LLC All players must complete this forms prior to the start of the 3 on 3. This injury waiver and release of liability is required by the facilities and our program as a precondition to usage and participation. NO PLAYER MAY PARTICIPATE UNTIL THIS FORM IS COMPLETED. INDIVIDUAL WAIVER, RELEASE AND INDEMNIFICATION OF LIABILITY FORM I, the undersigned, in consideration of being allowed to participate in an event or program sponsored by Changing The Culture, LLC or its related companies, acknowledge and fully understand that I will be engaging in activities that involve risk of serious injury, including permanent disability and possibly death, and severe social and economic loss, which may result from my own action, inaction or negligence as well as the actions, inactions and negligence of others. I acknowledge that I have been advised to consult with a physician before participating in the event or program. I hereby authorize the agents of Changing The Culture, LLC to act for me according to his/her best judgment in any emergency requiring medical attention I further agree to inspect the premises and equipment before playing each game and if I deem any conditions to be unsafe, I will advise the appropriate persons and will refuse to play. I assume all of the foregoing risks and accept personal responsibility for any injury, disability or death and any damages, whether social or economic, and agree to release, waive, indemnify and hold harmless Changing The Culture, LLC , subsidiaries and affiliated entities companies, officers, partners, directors, members, commissioners, referees, employees, agents, licensees, assigns, and facilities (hereinafter “Releasees”) from any and all liability to the undersigned, his or her heirs and next of kin, for any and all claims, demands, suits, costs, expenses, losses, awards, injuries or damages (including reasonable attorney fees and related costs) caused or alleged to have been caused by Releasees to myself or my child/children in connection with his/her/their/my participation in any Changing The Culture program, league, tournament or activity. I HAVE READ THE ABOVE WAIVER, RELEASE AND INDEMNIFICATION OF LIABILITY AND I UNDERSTAND THAT I AM VOLUNTARILY GIVING UP CERTAIN RIGHTS BY SIGNING IT. Filling in your full name, email address and checking The Box confirms you agree with all the above terms.

Step 2: