Current News

Basketball 3-point shootout registration

Basketball 3-point shootout registration

Article Displayed: 06/13/2019 - 07/26/2019

Click here for printable Basketball 3-point shootout registration

 

Shelby Fun Days

Basketball 3-point shootout Registration/Liability Waiver Form

 

PLAYER NAME: _____________________________________________________________

 

ADDRESS: ___________________________________________________________________

 

PHONE NUMBER: _____________________________________________________________

 

EMAIL ADDRESS: ______________________________________________________________

 

FEE: $3.00 PER SHOOTER-Male and Female Divisions: 11U, 14U, 18U Fee can be paid at Shelby City Hall with completed form.

 

For questions or more information email Mike Mantell mantell1@yahoo.com  or Michelle Mantell smu@walnutel.net or phone 712-544-2404.

 

 

 

1) I voluntarily elect or accept and solely assume all risks of damages, injury, including death, incurred or suffered by me (a) while practicing or playing as a member so designated, (b) while serving in a non-playing capacity as a team member or observer during practice of play by other teams or by other players on my team, and while on or upon the premise of any and all of the courts arranged for by my team or league for practice or play.

2) I release discharge and agree not to sue the team and/or league designated below or any owner or lease of courts on which basketball is played or practiced by my team and the City of Shelby, or their owners, officers, agents, servants, associations, employees, or any person or entity connected with the team, league, court for any claim, damages, costs or cause of action which I have or may in the future have as a result of injuries or damages sustained or incurred by me from whatever cause including but not limited to the negligence, breach of contract or wrongful conduct of the parties hereby released.

I further agree that I shall hold harmless and fully indemnify the parties hereby released from any claims, damages, costs including attorney fees, and cause of action which may arise from any claim or cause of action made by me, through me or on my behalf even if the damages, injuries or death are caused in whole or in part by any of the parties or entities hereby released.

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.

 

_________________________ ____________________________ ____________

Signature /Address /Date


Copyright © 2013 - 2019  City Hall ~ 417 East St. | P.O. Box 186 ~ Shelby, Iowa  51570 ~ 712-544-2404. All rights reserved.