NY Rising Rebels

Participant Waiver

The attached form must be completed and signed in all areas by the participant. By doing so, the signees acknowledge an understanding of the risks involved with partcipation in NY Rising Rebels Basketball programs & events. We do not anticipate any injuries or emergencies to occur during NY Rising Rebels events. However, in the case they do occur, we must be prepared with the proper documentation.

This form ensures safety and clear communication with all coaches, staff, umpires and officials, families and players, thus we require the attached information as part of our emergency plan of action.

By signing this form, the Participant affirms having read and agreed to the terms and conditions listed below.


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Participant Waiver Form

Participant Information

I have read and agree to the New York Rising Rebels Basketball Adult Participant Waiver Form. (Detailed Below)

New York Rising Rebels Basketball
Adult Participant Waiver


For and in consideration of NY Rising Rebels Basketball, LLC allowing the participant identified below (the "Participant") to participate in any NY Rising Rebels Basketball event, including, but not limited to, athletic competitions, games, tournaments, practices, camps, clinics, tryouts and related activities sponsored by NY Rising Rebels Basketball, LLC (the "Event" or "Events"); I, for myself, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the "Agreement"):

1. I hereby represent that (i) I am the participant (ii) I am in good health and in proper physical condition to participate in the Event; and (iii) I am not under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in the Event. I agree that it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in the Event, and that I am responsible for the my safety and well being at all times and under all circumstances while at the Event.

2. I understand and acknowledge the risks and dangers associated with the participation in the sport of field hockey, the Events and related activities, including without limitation, the potential for serious bodily injury, sickness and disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact with other participants, coaches, umpires, officials, spectators, animals or other natural or manmade objects; dangers arising from adverse weather conditions; imperfect field conditions; land, water and surface hazards; equipment failure; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Event Organizers; and other undefined, not readily foreseeable and presently unknown risks and dangers ("Risks"). I understand that these Risks may be caused in whole or in part by my own actions or inactions, the actions or inactions of others participating in the Event, or the negligent acts or omissions of the Released Parties defined below, I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or expenses which may be incurred as a result of the participation in any Event.

3. I understand that the I am required to be familiar with and to abide by the Rules and Regulations established for the Event, including but not limited to the Competitive Rules adopted by NY Rising Rebels Basketball, LLC and any safety regulations established for the benefit of all participants. I accept sole responsibility for my conduct and actions while participating in the Event.

4. By signing below, I hereby permit the placement of Participants' name, photo, and likeness on NY Rising Rebels Basketball's website and other promotional mediums and materials.

I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: NY Rising Rebels Basketball, LLC, its member athletes/players, clubs, coaches, umpires, trainers, officials; the Event Owners, Directors, Organizers, Promoters, Sponsors and Advertisers; the Host Facility/Venue and the Property Owners or Operators where the Event takes place; Law Enforcement Agencies and other Public Entities providing support for the Event; and each of their respective parent, subsidiary and affiliated companies, officers, directors, partners, shareholders, members, agents, employees and volunteers (Individually and Collectively, the "Released Parties" or "Event Organizers"), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorneys fees) of any kind or nature ("Liability") which may arise out of, result from, or relate in any way to the participation in the Event, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released Parties. I further agree that if, despite this Agreement, I the participant, or anyone on the Participant’s behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which any may be incurred as the result of such claim.

I hereby warrant that I am of legal age and authorized to enter into this Agreement, that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by signing it (including the rights of the heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge that I have signed this Agreement without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Agreement. This Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.


In addition, and without prejudice to the generality of any of the foregoing, I acknowledge that COVID-19 infections have been confirmed throughout the United States. I represent and warrant that I have not and that no-one that accompanies me to any NY Rising Rebels Basketball event has, within the past 14 days: (i) returned from any highly impacted area subject to a Level 3 Travel Health Notice issued by the Centers for Disease Control and Prevention (a “Level 3 Notice”); (ii) had exposure to any person returning from an area subject to a Level 3 Notice; or (iii) had exposure to any person who has a suspected or confirmed case of COVID-19.

I agree that I will not and I will not permit any other person to participate in any NY Rising Rebels Basketball event if I, he or she: (i) experiences symptoms of COVID-19; or (ii) has a suspected or diagnosed/confirmed case of COVID-19.

I agree that I and anyone else that accompanies me to any NY Rising Rebels Basketball event will comply with and submit to any and all policies, protocols, procedures or other requirements that NY Rising Rebels Basketball implements to protect the health and wellbeing of those who participate in or otherwise attend NY Rising Rebels Basketball events, including, without limitation, temperature checking and social distancing in accordance with the guidelines recommended by the CDC or other public health agencies. I fully understand and appreciate both the known and potential dangers of participating in and attending NY Rising Rebels Basketball events and acknowledge that both participants and attendees of such events may, despite NY Rising Rebels Basketball’s efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, hospitalization, disability and/or death. I voluntarily assume all such dangers and risks and accept sole responsibility for any illness, loss or Liability that may result from participating in or attending any and all NY Rising Rebels Basketball events.

I acknowledge and agree that the release, waiver, covenant not to sue and indemnification obligations previously set forth above extend to any Liabilities arising due to any person contracting or transmitting COVID-19 as a result of participating in or attending any and all NY Rising Rebels Basketball events.