RELEASE OF LIABILITY

I, the undersigned, hereby acknowledge and agree to release and hold Queen City Prep Basketball, all school facilities, all sponsors, employees, and volunteers associated with Queen City Prep Basketball, fully harmless from any injury, claim, legal fees or damage which may occur as a participating member of the Queen City Prep Basketball Program.  Further, I acknowledge that basketball is a contact sport and it involves traveling to, participating in and returning from games or sessions.  I agree to fully assume all risk, chance, hazard, and responsibility for my participation with Queen City Prep Basketball.

I acknowledge that I have read this hold harmless/release of liability form and I fully understand the contents. 

As the parent/guardian of the undersigned minor, I give permission to my son/daughter to participate in the Queen City Prep Basketball Program.

P.O. BOX 33664 / CHARLOTTE, NORTH CAROLINA 28233-3664 / PHONE: (704) 672-9952 / FAX: (704) 494-4005
Click on the down arrow to select your camp payment option. 
STEP 1:  Complete the form and submit
STEP 2:  Select the correct payment option and click Pay Now
Registration
Register for any of our events by completing and submitting this form.  Note:  all fields with an * must be completed before submitting this form.
Official PayPal Seal
Basketball Academy
 
 
*FULL NAME
*ADDRESS
*CITY, STATE, ZIP CODE
*TELEPHONE
EMAIL
AGE
DATE OF BIRTH
SCHOOL
*PARENTS' NAME
*EVENT