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AKYSB - Austin Basketball Clinic
40 spots are available for this event. It will be first come first served.
Additional entries will be placed on a waitlist. If you are on a waitlist, then you will be notified via email.
Who: Children (ages 10-14)
What: A 4-week Basketball Clinic to learn Basketball for children ages 10-14.
When: 04/02, 04/16, 04/23, 04/30 | Sundays | 10 AM to 12 PM
Where: Rouse High School
1222 Raider Way, Leander, TX 78641
How: Registration Fee: $55
Complete the form below and submit payment via Venmo (@SW_AKYSB). Be sure to include your name and AUS Basketball Clinic in the description. Spots are limited, so register today!
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Participant Information
Please provide the participant's information below.
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Must be 5 digits. Currently Entered: 0 digits.
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Must be a number between 10 and 14
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Gender *
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Rate your skill level. *
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How did you hear about the AKYSB Austin Basketball Clinic? *
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CONSENT AND RELEASE FORM
To be completed by the participant (18 years or older)
I, [Type Name Below], in exchange for being given the opportunity to participate in AKYSB AUSTIN BASKETBALL CLINIC (the “Activity”), hereby give consent and permission for myself to attend and participate in the Activity on the following date(s): April 2, 2023 to April 30, 2023.
I, on behalf of myself, my heirs, successors, assigns, and any other persons or entity claiming through or under any of them, waive my right to sue and hereby RELEASE, INDEMNIFY, and HOLD HARMLESS His Highness Prince Aga Khan Shia Imami Ismaili Council for the Southwestern United States (the “Council”), its regional/local councils, boards, portfolios, members, staff, volunteers, representatives and agents, including but not limited to the organizers, counselors and staff associated with the Activity (collectively, the “Indemnitees”) from and against any and all losses, claims, damages, causes of action, liabilities, costs, and expenses which may be asserted against the Indemnitees, if any, of every nature whatsoever, known or unknown, which arise out of or are connected with (1) any damages to person or property as a result of my participation or any other person's participation in the Activity; (2) any injury or death, including that arising, in part or whole, from the sole or contributory negligence of the Indemnitees, occurring during or related to the Activity and/or any travel which participation in the Activity may involve; (3) any policies, procedures, conduct, or negligent act or omission of the Indemnitees; and (4) any injury I may suffer due to the Activity or due to the facility where the Activity is taking place.
I hereby consent and grant permission to the Council and its Indemnitees to take photographs, videos, make recordings, and other media coverage (collectively, the “Captured Content”) of myself at or during the Activity, and to use, post or publish the Captured Content in various publications including but not limited to the internet, social media, newspapers, magazines, other print media, and marketing materials. I hereby disclaim any rights to and in such Captured Content, and release the Council and its Indemnitees from any claims, damages or liability relating to same.
I hereby consent to any medical or surgical treatment which I may need and which arises in connection with the Activity; provided, however, nothing contained herein shall be deemed an obligation on the Council or its Indemnitees to provide any such medical or surgical treatment. I understand that the Council and Indemnitees do not carry healthcare insurance that covers me and therefore, I am solely responsible for the cost of all medical and surgical treatment.
I explicitly agree that any transportation required to and from the Activity shall be undertaken solely at my own risk.
Any controversy or claim arising out of or relating to the Activity or this Consent & Release Form shall be settled by binding arbitration administered by the His Highness Prince Aga Khan Shia Imami Ismaili Conciliation and Arbitration Board for the United States of America, and its decision shall be final and binding on all parties.
I acknowledge that should any part of this Consent & Release form be determined to be invalid or without full legal effect, such determination shall not invalidate the remaining portions thereof, which shall remain in full force and effect.
I HAVE READ AND VOLUNTARILY SIGN THIS CONSENT & RELEASE FORM AND INTEND IT TO BE A COMPLETE, FULL AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
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CONSENT AND RELEASE FORM
To be completed by the parent or guardian of the participant:
I, the aforementioned Parent/Guardian, in exchange for my child being given the opportunity to participate in AKYSB AUSTIN BASKETBALL CLINIC (the “Activity”), hereby give consent and permission for my son/daughter, (the “Participant”) to attend and participate in the Activity on the following date(s): April 2, 2023 to April 30, 2023.
I, on behalf of myself, my spouse, if applicable, the Participant, and my heirs, successors, assigns, and any other persons or entity claiming through or under any of them, waive my right to sue and hereby RELEASE, INDEMNIFY, and HOLD HARMLESS His Highness Prince Aga Khan Shia Imami Ismaili Council for the Southwestern United States (the “Council”), its regional/local councils, boards, portfolios, members, staff, volunteers, representatives and agents, including but not limited to the organizers, counselors and staff associated with the Activity (collectively, the “Indemnitees”) from and against any and all losses, claims, damages, causes of action, liabilities, costs, and expenses which may be asserted against the Indemnitees, if any, of every nature whatsoever, known or unknown, which arise out of or are connected with (1) any damages to person or property as a result of the Participant’s participation or any other person's participation in the Activity; (2) any injury or death, including that arising, in part or whole, from the sole or contributory negligence of the Indemnitees, occurring during or related to the Activity and/or any travel which participation in the Activity may involve; and (3) any policies, procedures, conduct, or negligent act or omission of the Indemnitees; and (4) any injury I or the Participant may suffer due to the Activity or due to the facility where the Activity is taking place.
I hereby consent and grant permission to the Council and its Indemnitees to take photographs, videos, make recordings, and other media coverage (collectively, the “Captured Content”) of the Participant or myself at or during the Activity, and to use, post or publish the Captured Content in various publications including but not limited to the internet, social media, newspapers, magazines, other print media, and marketing materials. I hereby disclaim any rights to and in such Captured Content, and release the Council and its Indemnitees from any claims, damages or liability relating to same.
I hereby consent to any medical or surgical treatment which the Participant may need and which arises in connection with the Activity; provided, however, nothing contained herein shall be deemed an obligation on the Council or its Indemnitees to provide any such medical or surgical treatment. I understand that the Council and Indemnitees do not carry healthcare insurance that covers the Participant and therefore, I am solely responsible for the cost of all medical and surgical treatment.
I explicitly agree that any transportation required by the Participant to and from the Activity shall be undertaken solely at my own risk.
Any controversy or claim arising out of or relating to the Activity or this Consent & Release Form shall be settled by binding arbitration administered by the His Highness Prince Aga Khan Shia Imami Ismaili Conciliation and Arbitration Board for the United States of America, and its decision shall be final and binding on all parties. I acknowledge that should any part of this Consent & Release form be determined to be invalid or without full legal effect, such determination shall not invalidate the remaining portions thereof, which shall remain in full force and effect.
I HAVE READ AND VOLUNTARILY SIGN THIS CONSENT & RELEASE FORM AND INTEND IT TO BE A COMPLETE, FULL AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
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I understand this is a legal representation of my signature.
Clear
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