2014-15 Dribble, Dish & Swish Participant Form

Insert DDS logo
RELEASE AND ELIGIBILITY FORM
RELEASE AND ELIGIBILITY FORM
For good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, and in connection with my
For good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, and in connection
admission
and/or voluntary
participation
the NBA FIT Dribble,
Swish,
(the ‘Event’),
I hereby:
with myto,
admission
to, and/or
voluntaryin,participation
in, theDish
NBA&FIT
Dribble,
Dish & Swish,
(the ‘Event’), I hereby:
1.acknowledge
acceptsole
sole
responsibility
forofall
the hazards
and
to my
meproperty
and myassociated
propertywith
associated
1. acknowledge and
and accept
responsibility
for all
theofhazards
and risks
to risks
me and
or relatwith
to myinparticipation
and
anythat
damage
or injury
that I may cause to others;
ed
to or
myrelated
participation
the Event and in
forthe
anyEvent
damage
or for
injury
I may cause
to others;
2. release, waive and forever discharge any and all claims of damages or causes of action, including but not limited to,
2.
release,
waive injury
and forever
anytoand
all claims
of damages
of action, including
to, death,
death,
personal
or lossdischarge
or damage
property,
which
I or anyor
of causes
my representatives,
heirs,but
nextnot
of limited
kin or assignees
personal
injury or loss or damage
to property,
I or any of my
representatives,
heirs,
next of kin or assignees
(myof my
(my “Representatives”)
may have
or whichwhich
may hereinafter
accrue
to me or my
Representatives
as a result
voluntary participation
in or
thewhich
Event
otherwiseaccrue
and which
be asserted byasme
or my
Representatives
“Representatives”)
may have
mayorhereinafter
to me ormay
my Representatives
a result
of my
voluntary particagainst NBA Properties, Inc. (“NBAP”), NBA Entertainment (a division of NBAP), NBA Media Ventures, LLC, NBA
ipation in the Event or otherwise and which may be asserted by me or my Representatives against NBA Properties, Inc.
Store, LLC, the National Basketball Association and any of its member teams, any sponsor, promoter or advertiser
(“NBAP”),
NBAand
Entertainment
division of NBAP),
Media
Ventures, LLC,
Store, (collectively,
LLC, the National
Basketball
Associaof the Event,
any of their(arespective
relatedNBA
entities,
subsidiaries
andNBA
affiliates
“Released
Entities”),
and and
for each
such
Released
Entity,
itssponsor,
respective
officers,ordirectors,
governors,
officials,
volunteers,
tion
any of
its member
teams,
any
promoter
advertiserowners,
of the Event,
and any
of their
respectiveemployees,
related
agents representatives,
successors,
and assigns
(collectively,
andand
together
with
theReleased
ReleasedEntity,
Entities,
the “Releasees”),
entities,
subsidiaries and affiliates
(collectively,
“Released
Entities”),
for each
such
its respective
officers,
whether caused by the acts, omissions or negligence of any Releasee or by any other person or entity;
directors, owners, governors, officials, volunteers, employees, agents representatives, successors, and assigns (collectively,
and together
with the
Entities,
the “Releasees”),
whether caused
by theto
acts,
omissions
or negligence
of any Re3.grant
permission
toReleased
the Released
Entities
(or their respective
licensees)
utilize
my name,
voice, statements,
photograph,
image,
likeness,
actions and/or biographical data in any live or recorded form (including, but not
leasee
or by any
other person
or entity;
2014—2015
2014 – 2015
OFFICIAL
OFFICIAL
REGISTRATION
FORM &
REGISTRATION FORM
SCORESHEET
& SCORESHEET
limited to, any form of video display or other transmission or reproduction), in whole or in part, for promotional,
commercial or any other purpose, in perpetuity worldwide in any media whether now known or hereafter created
3.
grant permission
to the consideration;
Released Entitiesand
(or their respective licensees) to utilize my name, voice, statements, photograph,
without
any additional
image, likeness, actions and/or biographical data in any live or recorded form (including, but not limited to, any form of video
4. display
represent
that,transmission
if this form isornot
signed below
by my
I amcommercial
eighteen or
(18)
years
age or older.
or other
reproduction),
in whole
or parent
in part, or
forguardian,
promotional,
any
otherofpurpose,
in
perpetuity worldwide in any media whether now known or hereafter created without any additional consideration; and
AGREED TO AND ACCEPTED:
4. represent that, if this form is not signed below by my parent or guardian, I am eighteen (18) years of age or older.
Name: ___________________________________________________________________
AGREED TO AND ACCEPTED:
Age (provide only if Participant is under 18): ___________
Name: ___________________________________________________________________
Signature: ____________________________________________________ Date: _______________________
Age (provide only if Participant is under 18): ___________
THE FOLLOWING MUST BE COMPLETED IF PARTICIPANT IS UNDER 18 YEARS OF AGE
Signature: ________________________________________________________________ Date: ___________________
In consideration of the Participant’s participation in, or admission to, the Event, I, by my signature below, and in my
capacity as Participant’s parent or guardian, hereby (a) give permission for the Participant, who is my child or ward,
THE
MUST
BE COMPLETED
IF PARTICIPANT
IS UNDER
18 acknowledge
YEARS OF AGE and agree to all of the terms set forth in
to FOLLOWING
attend, and/or
participate
voluntarily
in, the Event
and (b)
Release and
Eligibility
Form.
Inthis
consideration
of the
Participant’s
participation in, or admission to, the Event, I, by my signature below, and in my capacity as
Participant’s parent or guardian, hereby (a) give permission for the Participant, who is my child or ward, to attend, and/or particiName
of Parent
or Guardian:
___________________________________________
pate
voluntarily
in, the
Event and (b)
acknowledge and agree to all of the terms set forth in this Release and Eligibility Form.
Name
of Parent
or Guardian:
___________________________________________
_
Signature
of Parent
or Guardian:
________________________________________
Date: ___________________
Signature of Parent or Guardian: __________________________________________ Date: ___________________
FOR MORE INFORMATION VISIT:
FOR MORE INFORMATION VISIT
www.nba.com/nbafit
nba.com/nbafit/dribbledishswish
#NBACaresNYC15
PROGRAM GOALS
2014-15 OFFICIAL REGISTRATION FORM
To provide young players across the Tri-State Area (including Connecticut, New Jersey,
and New York) with an opportunity to participate, free of charge, in an exciting fitness and
basketball skills competition; to provide youth organizations with an easily administered
PROGRAM
GOALS
program
that communicates
effectively, supplies consistent and timely information, and
delivers
all materials
on schedule
an effort to provide the highest quality program of its kind.
To provide
youngsters
across theinTri-
PARTICIPANT’S NAME: _________________________________________________________
NBA FIT Dribble, Dish & Swish is intended to encourage youth participation and emphasize
both fitness elements and basketball competition. Since there is no registration fee for
this program, every boy and girl, 7-12 years of age, may qualify to compete in three (3) levels
ule in an effortwhile
to provide
the highest
quality
programskills
of itsand
kind.
of competition
emphasizing
core
basketball
focusing on fitness.
COMPETITION RULES
• All participants MUST provide a copy of a valid birth certificate or other proof of identification
at all levels of competition.
while emphasizing the core basketball skills and focusing on fitness.
• Each player may participate in only one (1) Local Competition. Competing in more than
one (1) Local Competition will result in disqualification.
• IfCOMPETITION
a tie for 1st Place occursRULES
at a Local Competition, each player involved in the tie must
repeat the competition to determine the Champion. The best time from the tiebreaker
will be used to determine the Champion. The Champion’s original time will be the time
submitted to NBA FIT Dribble, Dish & Swish Headquarters. At the Local Level, if a tiebreaker
cannot be held due to participants exiting after competition, then each player involved
in the tie will be deemed Co-champion.
• If a tie occurs for 1st Place at the Regional Competition, the time from each player’s
Local Competition will be used to determine the winner. NBA FIT Dribble, Dish & Swish
Headquarters will use the submitted time from both players’ local competitions to
determine the winner at the Regional Competition. The Champion’s original time from
the Regional Competition will be the time submitted to post against other qualified
champion.
times for possible advancement to All-Star Finals.
• If a tie occurs for 1st place at All-Star Finals, each player must repeat the competition to
determine the champion. The best time from the tiebreaker will be used to determine
the Champion.
• In the event of cancellations, rescheduling will be determined by NBA FIT Dribble, Dish
& Swish officials at the competition site. At the Local Level, the League Director/Local
Competition Administrator will be the determining official.
• The NBA and its sponsors, LEJ & Associates, Inc., local and regional coordinators/organizers
Champion.
of
NBA FIT Dribble, Dish & Swish, reserve the right to make rulings and recommendations
regarding the competition determined to be in the best interest of the program. All
rulings and recommendations are final.
ministrator
will be the determining
official.
• Local
Champions/1st
place winners
in each age and gender group will automatically
• The NBAtoand
sponsors,Competition.
LEJ & Associates,
Inc.,the
local
and regional
coordinators/organizers
of
advance
theitsRegional
From
Regional
Competition,
the champion
in each age and gender group qualifies to advance to the All-Star Finals. Regional
competition champions will then have their times ranked amongst the four (4) Regional
Competitions. The top two (2) finishers in each age and gender group will advance to
the All-Star Finals.
PARENT’S NAME: ____________________________________________________________
2014-15 OFFICIAL REGISTRATION FORM
STREET ADDRESS: ___________________________________________________________
PARTICIPANT’S
NAME: ___________________________________________________________
CITY_________________________________
STATE ____________ ZIP________________
PARENT’S NAME: _______________________________________________________________
PHONE (DAY) _____________________________ (EVENING)__________________________
STREET ADDRESS: _______________________________________________________________
EMAIL ADDRESS_____________________________________________________________
CITY________________________________ STATE __________________ZIP________________
AGE AS OF FEBRUARY 14, 2015 ______________
BIRTHDATE _______/__________/________
PHONE (DAY) _________________________________ (EVENING)________________________
AGE VERIFICATION CHART (circle the age group that applies)
EMAIL ADDRESS________________________________________________________________
Ages
February 15,
2006 – February
14, 2008
BIRTHDATE
_______/__________/________
AGE AS OF FEBRUARY
14, 7-8
2015 ______________
AgeAGE
9-10
February
15, 2004
– February
2006
VERIFICATION
CHART (circle
the age
group that 14,
applies
9 and underFebruary
February 15,
15, 2005
14, 14,
20152004
AgesAges
11-12
2002to–February
February
Ages 10-11
Ages 12-13
GENDER: Male OR Female
February 15, 2003 to February 14, 2005
February 15, 2001 to February 14, 2003
GENDER: Male OR Female
LOCAL HOSTING ORGANIZATION __________________________________________________
LOCAL HOSTING ORGANIZATION __________________________________________________
HOSTING FACILITY __________________________________________________________
HOSTING FACILITY _____________________________________________________________
PLEASE NOTE: ALL of the above fields are REQUIRED.
PLEASE NOTE: ALL of the above fields are REQUIRED.
• DO NOT MARK BELOW THIS LINE •
DO NOT MARK BELOW THIS LINE •
2014-15 OFFICIAL
SCORESHEET
2014-15
OFFICIAL SCORESHEET
Time (.01)
(example: 22.18)
# of Penalties
Penalty Time
Final Time
VIOLATIONS: a three second (3.00) penalty will be added to participant’s final
VIOLATIONS time for EACH violation.
•Traveling
• Traveling
• Double dribbling
• Double
dribbling the ball
• Palming/Carrying
• Palming/Carrying
theinball
• Taking shot on or
front of the regulation foul line/10ft. shooting line
• Missing an orange/yellow cone
• Missing
anthe
orange/yellow
• Passing
basketball tocone
the passing coach without at least one (1) foot
• Passing
the
basketball
to
the
passing coach without at least one (1) foot on the passing
on the passing spot
spot
• Receiving the basketball from the passing coach without at least one (1) foot
• Receiving the basketball from the passing coach without at least one (1) foot on the passon the passing spot
ing spot
*ALL
rulings
made
Court
Official
FINAL.
*ALL
rulings
made
byby
Court
Official
areare
FINAL.