JTH WAIVER FORM

ACTIVITY: Basketball institute run by Jump Thru Hoops (“JTH”) and related events and activities (the “Program”)

I, (Your name that appears on the form below) agree to fully and forever release and discharge JTH and their respective directors, officers, agents, employees, contractors, volunteers, affiliates and representatives (collectively the “Releasees”) from any and all liability that they or any of them may have, and I waive any and all claims I may now and in the future have against the Releasees (whether known, unknown, anticipated or unanticipated), for any personal injury, disability, paralysis, death, property damage or other loss, sustained by me in connection with, or as a result of, my participation in the Program, due to any cause whatsoever, including without limitation the negligence of any of the Releasees.

I acknowledge that there are certain risks involved in my participation in the Program, in addition to the usual risks and dangers inherent in any physical activity, including without limitation slips, falls, physical contact with another person and malfunction of equipment or facilities. I further acknowledge that my participation in the Activity could result in personal injury, disability, paralysis, death, or loss or damage to person or property. I hereby fully assume and accept any and all of the dangers and risks, both known and unknown, even if arising from the negligence of the Releasees, connected with, or related in any way to, my participation in the Program. I agree that this Agreement constitutes a legally binding obligation enforceable in accordance with its terms and governed by the laws of the Province of Ontario and of Canada, and that it shall continue to bind me and my next of kin, heirs, executors, legal representatives and personal assigns. I submit to the jurisdiction of the Province of Ontario in connection with this Agreement.

I grant full permission to JTH and/or agents authorized by JTH, to use any photograph, video footage and/or electronic sound recording of me for their website and other JTH media accounts, and be used for media purposes including promotional presentations, education purposes and coursed and marketing purposes by JTH. The Participant waives rights to privacy and compensation which they may have in connections with such use of the Participants likeness, including rights to any financial or other remuneration. I confirm that I am 18 years of age, that I have completely read this Agreement and that I fully understand the provisions of this Agreement. I understand that by signing this Agreement I am giving up my legal rights including the right to sue.

By submitting this form, I confirm that I am 18 years of age, that I have completely read this Agreement and that I fully understand the provisions of this Agreement. I understand that by signing this Agreement I am giving up my legal rights including the right to sue.

Participant's Full Name

Today's Date

Emergency Phone Number

PARENTAL CONSENT FOR PARTICIPANTS UNDER THE AGE OF 18: This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above

Parent's Fullname

Witness' Name

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