Republic of the Philippines

Province of Tarlac
MUNICIPALITY OF CAMILING

OFFICE OF THE SANGGUNIANG KABATAAN NG BARANGAY BILAD

BILAD BASKETBALL TOURNAMENT
PLAYERS WAIVER FORM 2023

Team Name: _____________ Player’s Name: ___________________

Address: ___________________ Age: _____ Birthdate: ______________
Phone Number: ______________ Contact number in case of Emergency: ___________________
Relationship: ________________

I, the undersigned, player, acknowledge, agree and understand that:

1. There are certain risks of damages and injuries, including death, inherent in the practice
and play of basketball, as well as in traveling in other related activities incidental to me,
and I am willing to assume these risks. These risks include but are not limited to those
hazards associated with weather conditions, travel, playing conditions, equipment and
other participants.
2. The very nature of the game of basketball is hazardous and risky, including but not
limited to, the acts of running, jumping, stretching, sliding, diving, and collisions with
other players and with stationary objects, all of which can cause serious injury or death
to me and to other players.
I certify that I am physically fit, have sufficiently trained for participation in this event, and have
not been advised otherwise by a qualified medical person.
Further, I agree that in consideration for the right to allow me as a member of the team
designated below and in consideration for permission to play at the sites arranged for by the
team or league:
1. I do voluntarily elect to accept and solely assume all risks of injury incurred or suffered
(a) while practicing or playing as a member of the team so designated, (b) while serving
in a non-playing capacity as a team member or observer during practice or play by other
teams or by other players on my team, and (c) while on or upon the premises of any and
all of the fields arranged for by my team or league for practice or play.
2. In addition to giving my full consent for participation, I do hereby waive, release,
discharge and agree not to sue the team and league designated below, the owner or
operator of any sites or other entity, the Sangguniang Kabataan of Bilad, Camiling,
Tarlac and elected officials in the Barangay, employees and volunteers or any person or
entity connected with the team, league for any claim, damages, costs including attorney’s
fees, or cause of action which I may have in the future as a result of damages, injuries,
including death, sustained or incurred by my participation.
I ACKNOWLEDGE THAT I HAVE READ AND THAT I UNDERSTAND EACH AND EVERY
ONE OF THE ABOVE PROVISIONS IN THIS WAIVER, RELEASE OF LIABILITY AND
INDEMNIFICATION AGREEMENT AND AGREE TO ABIDE BY THEM.

Player’s Signature (Over Printed Name): __________________ Date signed: _________

Parent’s Signature (If the player is below 18 years old): __________________________