On behalf of my minor child ____________________________, I hereby apply for his/her participation
in Saratoga NJB and do request Saratoga NJB to accept this application. I hereby warrant that both
my child and myself are familiar with the risks associated with participation in an active sport
such as basketball. Furthermore, I warrant that my child is in good health, has no condition which
would interfere with his/her participation, and would not be adversely affected by such participation.
In short, my child is active, in good health, and anxious to play basketball. I do hereby agree and
consent to my child’s participation in Saratoga NJB during the current season and do assume all risks
and hazards which are part of the conduct of the associated activities. I hereby release, absolve,
indemnify, and hold blameless the Saratoga NJB League, a California non-profit corporation, its officers,
directors, employees, agents and their sponsors, organizers, and supervisors of any and all liability
for damage, injury, or expense of any kind arising out of or connected with my child’s participation in
Saratoga NJB. I further understand that in case of a medical emergency, my own personal medical plan,
if I have one, will be used. Participation in competitive athletics may result in serious injury. It
is impossible to totally eliminate such occurrences from competitive sports. Players can reduce the risk
of serious injury by obeying safety rules, following a proper conditioning program, and maintaining their
equipment properly.

EVEN IF ALL OF THESE REQUIREMENTS ARE MET, AND EVEN IF THE ATHLETE IS
IN EXCELLENT PHYSICAL CONDITION WITH PERFECT EQUIPMENT, A SERIOUS ACCIDENT
MAY STILL OCCUR. AS A CONDITION OF PARTICIPATION IN THE SARATOGA NJB PROGRAM
BY THE PLAYER NAMED IN THIS APPLICATION, I ACKNOWLEDGE THAT I HAVE READ THIS
CONSENT FORM, AND KNOWINGLY, ON BEHALF OF MY CHILD, ASSUME ALL OF THE RISKS
ASSOCIATED WITH PARTICIPATING IN ANY WAY IN THE SARATOGA NJB PROGRAM.

Signed _________________________________ Date ____________________

California Corporate ID 9556804 Tax Exempt 501c General Liability
Carrier :Bollinger Insurance 101 JFK Parkway, Short Hills NJ 07078