TEAM REGISTRATION FORM
Team Name: (must have a name)
Player 1 (Captain; Name/Age)
Address & Phone Number
Player 2 (Name/Age)
Player 3 (Name/Age)
Player 4 (Name/Age)
Age Group: (check a divison and a bracket)
☐13 and under (check one) ☐Male ☐Female ☐14 to 17 (check one) ☐Male ☐Female
☐18+ Co-ed
Please mail complete entry form and check or money order (payable to NHBP) to:
NHBP Attn: Tiesha Williams
1485 Mno-Bmadzewen Way | Fulton, MI 49052
For questions, call 269.704.8374
33
NHBP 3rd ANNUAL
on
FRIDAY, JUNE 19, 2015
OPEN TO THE PUBLIC!
3 Divisions & Contests!
4 Person Team Entry Fee: $40
REGISTRATION DEADLINE: JUNE 12
BASKETBALL
TOURNAMENT
Agreement Regarding Risk of Injury and Release
• I hereby apply to participate in the NHBP 3rd Annual 3-on-3 Basketball Tournament at the Pine Creek Reservation in
Fulton, MI on June 19, 2015.
• I understand that participating in the tournament will expose me to above normal risks. These risks include uneven or
hazardous playing surfaces, physical contact or collision with other players, spectators or inanimate objects on or about
the court. I understand that the sport of basketball is in itself hazardous and may result in injury to me or other players. I
represent that I have no health or physical problems that will interfere with my participation in the tournament.
• I agree that I am responsible for my own safety.
• I hereby assume all risk associated with my attendance and participation in the tournament. I further agree that my
attendance, play, and participation in the tournament shall be at my sole risk and decision as to whether or how I play
shall be entirely my responsibility.
• I hereby fully release and discharge the Pine Creek Reservation and its employees, the City of Fulton, and the Tournament
Organizers from any and all claims, causes of actions or liability arising out of negligence of the Pine Creek Reservation
and its employees, or the City of Fulton from any loss, damage or expense sustained or incurred by them, arising from
any such claims, cause of action or liability, whether brought on by me, or anyone acting on my behalf, or by anyone else
because of conduct attribute to me.
• I agree that this agreement shall be construed and interpreted according to the laws of the Nottawaseppi Huron Band of
the Potawatomi. I agree with this agreement and release shall be binding upon my heirs, assigns and any personal entity
upon my behalf, including parent, guardian of next of kin.
THIS WAIVER SHALL SERVE AS THE WAIVER FOR THE ENTIRE TEAM LISTED
Team Name: Player Signature
Parent Signature (players under 18)
1.
2.
3.
4.
This waiver must be submitted before your team will be allowed to play in this tournament.
Please mail complete entry form and check or money order (payable to NHBP) to:
NHBP Attn: Tiesha Williams
1485 Mno-Bmadzewen Way | Fulton, MI 49052
For questions, call 269.704.8374