Camp Registration is open to the students of the Five Towns Community

  • Use this form to register for camps only.

    If you need to register for a different event, please go back to the home page.
  • -
  •  /  / Pick a Date
  • Medical and Liability Release

    • Release 
    • In return for my child (Player) being allowed to participate in the Five Town Basketball, Five Town Hoop Dreams, or any of its events, (the Program) I release and agree not to sue the program, its members, and their employees,  sub-contractors, sponsors, agents, and affiliates from all present and future claims that may be made by the Player or me, my family, estate, heirs, or assigns for property damage, personal injury, or wrongful death arising as a result of the Players participation in the Program, and caused by the ordinary negligence of the parties listed above, wherever, whenever, or however the same may occur. I understand and agree that those listed above are not responsible for any injury or property damage arising about of the Program, even if caused by their ordinary negligence. I understand that participation in the Program involves certain risks, including, but not limited to serious injury. I am voluntarily allowing Player to participate in the Program with knowledge of the danger involved and agree to accept all risks of such participation.

      I certify that the Player is in excellent physical health and may participate in strenuous and hazardous physical activities, including basketball to be played in the Program. I also certify that the Player has permission to be transported by members of the program. Permission is granted for Player to receive emergency medical treatment, if needed. I also agree to indemnify and hold harmless those listed above for all claims arising out of Players participation in the Program and all related activities. I agree to let the parties use Players name and likeness free of charge in any manner and for any purpose without compensation to Player or me. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Program is taking place and agree that if any portion of the agreement is invalid, that the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in the state of Maine.

      I am the parent or legal guardian of the Player. I am of legal age and am freely signing this agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I represent that I am parent/legal guardian of the child named above, and agree that the terms of this release are biding on me and the Player.

      Liability Clause

      I/we the Parents/legal Guardian of the above named Player in the Five Town Basketball, Five Town Hoop Dreams hereby give my/our approval to their participation in any and all activities during the season. I/We assume all risks and hazards incidental to such participation, including transportation to and from all activities. I/We hereby waive, release, absolve, indemnify and agree to hold harmless the Five Town Basketball, Five Town Hoop Dreams Programs, its organizers, sponsors, supervisors, board members, other Players, and any persons transporting the Player, except the extent and in the amount covered by accidental or liability insurance.

      Consent

      I/We by signing below authorize Five Town Basketball, Five Town Hoop Dreams to input the above named Players information into the Five Town Basketball, Five Town Hoop Dreams database. I/We understand that this information may have to be sent electronically and I/We will not hold Five Town Basketball, Five Town Hoop Dreams responsible for the security of such transmission.

    • You must agree to accept the terms in the Medical and Liabilty Release Agreement to continue the registration process.

    • Reload
    • FTBB pays for 50% of camp registration fee.  
      FTBB will send full registration fee to camp once FTBB receives 50% of camp registration from the team.

    • Please make your check payable to:

      Five Town Basketball
      PO Box 874
      Rockport, ME 04856

      Be sure to write your school name on the memo line in CAPITAL LETTERS.

    • USD
    •    
    • Should be Empty:
 
 
 
{BLOCK_SIDE2}
 
Our Disclaimer
Five Town Hoop Dreams, Five Town Basketball, any of it's board members, is not affiliated in anyway, or financially supported by, the Five Town CSD, MSAD #28, School Union 69, or any school within those districts.  Funding and support for Five Town Hoop Dreams and/or Five Town Basketball is provided exclusively by area businesses, civic organizations, private persons, and community donations at fund raising events.  All board members and coaches are unpaid volunteers.
 
Privacy Policy  |  Terms of Use  |  Email |  Admin Area  |  Contact Us
(C)2013 | info@fivetownhoopdreams.net | CKD Website Designs