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.
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