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Grizzlies 2024/2025 Season Registration Form
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Participant Information
Contact Email
*
Participant First Name
*
Participant Last Name
*
Participant Birthdate
*
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Participant Gender
*
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Female
Country
*
-- select country --
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Street Address (w/Apt#)
*
City
*
State
*
-- select state --
Alabama
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-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select province --
Alberta
British Columbia
Manitoba
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Northwest Territories
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Ontario
Prince Edward Island
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County
*
-- select county --
Adair County
Adams County
Allamakee County
Appanoose County
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Benton County
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Boone County
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Buena Vista County
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Emmet County
Fayette County
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Guthrie County
Hamilton County
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Hardin County
Harrison County
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Ida County
Iowa County
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Page County
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Union County
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Zip Code
*
Phone
*
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on this number (eg. changes or delays)?
Emergency Contact Name
*
Emergency Phone
*
Player/Parent Agreement
*
As a Grizzlies player and parent, I agree to the following: • Cost: $250.00 non-refundable registration. This fee will help cover all tournament team registration fees, coaching costs, and practice venue rentals. • Season: This season will start on September 14th, 2024. First time, new players can be added to the team until January 1, 2025. The season will conclude with the Conference Tournament unless the team is invited and accepts a bid to the Junior National Wheelchair Basketball tournament. • Equipment: Sports chairs are required. If you do not have your own, one may be borrowed from Adaptive Sports Iowa. Maintenance and repairs of personal chairs are the responsibility of the athlete; however, Adaptive Sports Iowa will assist when possible. • Uniforms: Initial uniforms are included. During the season it is the player’s responsibility to maintain the cleanliness and appearance of their uniform. Players and parents are responsible for bringing clean uniforms with them to all events, tournaments, and exhibition games. If a player fails to bring and/or maintain cleanliness of their uniform, they could be subject to restrictions from gameplay that day. • Code of Conduct: I commit to being a player of the Adaptive Sports Iowa Grizzlies Prep team and/or Junior Varsity team. I agree to abide by the National Wheelchair Basketball Association (NWBA) code of conduct (signed virtually when registering with the NWBA) and Adaptive Sports Iowa’s code of conduct. As a player, I will represent Adaptive Sports Iowa at all events. • Team Commitment: As a player and parent I commit to attend practices, tournaments, and special events where presence of the Grizzlies players is requested by coaches and/or ASI. If unable to attend, players are asked to give proper notification to coaches a minimum of 72 hours prior to the event. • Fundraising: We request players and parents assist with fundraising as plans and opportunities are available.
Read through the agreement.
I have read and agreed to the TERMS
*
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
Student T-shirt/Jersey Size
*
Waiver
*
PART "A" - WAIVER & RELEASE FROM LIABILITY In consideration of being permitted to enter for any purpose any RESTRICTED AREA (herein defined as the areas to which admission by general public spectators is prohibited and in addition, consisting of the planned route, or any other area which the participant chooses to access by any mode of transportation), or being permitted to compete, officiate, observe, work for, or for any purpose participate in any way in the event, EACH OF THE UNDERSIGNED, for himself/herself, his/her personal representatives, heirs, next of kin, acknowledges, agrees and represents that he/she has, or will immediately upon entering any of such restricted areas, and will continuously thereafter, inspect such restricted area or areas and all portions thereof which he/she enters and with which he/she comes in contact, and he/she does further warrant that his/her entry upon such restricted area and that he/she finds and accepts the same as being safe and reasonably suited for the purpose of his/her use, and further agrees and warrants that if, at any time, he/she is in or about restricted areas and he/she feels anything to be unsafe, he/she will immediately advise the officials of such and will leave the restricted area(s): 1.HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the Iowa Sports Foundation, d/b/a/ Adaptive Sports Iowa, its affiliated clubs, organizations and licensed medical professionals, their respective administrators, officers, directors, representatives, agents, coaches, the promoters, hosts, other participants, operators, officials, sponsors, advertisers, owners and lessees of premises used to conduct the event and each of them, their officers, and employees, all for the purposes herein referred to as "releasees", from all liability to the undersigned, his/her personal representatives, assigns, heirs and next of kin for any and all damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned, whether caused by the negligence of the releasees or otherwise while the undersigned is in or upon the restricted area, and/or competing, officiating in, observing, or working for, or for any purpose participating in the event; 2.HEREBY AGREES TO INDEMNIFY AND SAVE HOLD HARMLESS the releasees and each of them from any loss, liability, damage, or cost they may incur due to the presence of the undersigned in or upon the restricted area or in any way competing, officiating, observing, or working for, or for any purpose participating in the event and whether caused by the negligence of the releasees or otherwise. 3.HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE due to the negligence of releasees or otherwise while in or upon the restricted area and/or while competing, officiating, observing, or working for or for any purpose participating in the event. 4.EACH OF THE UNDERSIGNED expressly acknowledges and agrees that the activities at the event and in the restricted areas are dangerous and involve the risk of serious injury and/or death and/or property damage. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. 5.Hereby consent to allow my picture and/or voice or likeness to appear in any official documentary, promotional, exclusive television, radio or film coverage of the Iowa Sports Foundation, d/b/a/ Adaptive Sports Iowa in any manner incidental to my participation in the Iowa Sports Foundation, d/b/a Adaptive Sports Iowa and without compensation to me. THE UNDERSIGNED HAS READ THIS WAIVER AND RELEASE FROM LIABILITY, FULLY UNDERSTANDS ITS TERMS, UNDERSTANDS THAT SUBSTANTIAL RIGHTS ARE GIVEN UP BY SIGNING IT, AND SIGNS IT FREELY AND VOLUNTARILY, and further agrees that no oral representatives, statements or inducement apart from the foregoing written agreement have been made. This waiver, release and indemnification agreement, specifically embraces each and every event sanctioned, authorized, sponsored, co-sponsored, or promoted by said releasees during the entire season, including, without limitation, local or regional qualifying events, wherever located, and applies to each and every event, or activity hereinabove mentioned, and has the same effect as if executed after each and every activity or event in which the undersigned participates so that the parties herein intended to be released and indemnified shall be fully and effectively released and indemnified as to each and every event hereinabove described. PART "B" - PARENT/GUARDIAN WAIVER - RELEASE FROM LIABILITY (all parents/guardians must read) The parent/guardian of said minor, does thereby represent that he/she (they) is (are), in fact, acting in such capacity and agrees to save and hold harmless and indemnify each and all of the parties herein referred to above as releases from all liability, loss, cost, claim or damage whatsoever may be imposed upon said releasees because of any defect in or lack of such capacity to so act and release said releasees on behalf of both of the undersigned.
Read through the agreement.
I have read and agreed to the TERMS
*
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
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