Harding Township Recreation Association
keeping sports fun for everyone
REGISTER
BASKETBALL
PLAYER
/ /
Male Female
PRIMARY CONTACT
BE A VOLUNTEER!OPTIONAL?
ADDITIONAL CONTACT
EMERGENCY CONTACT
PHYSICIAN

I permit my child to participate in all activities of the HTRA basketball program.

I assume all risks and hazards incidental to the conduct of, and transportation to and from, those activities.

I release, absolve, indemnify and hold harmless the HTRA and all program organizers, sponsors, members, supervisors, coaches, instructors, their agents, representatives and assigns from any and against any and all liability or responsibility arising from or related to the conduct of, or transport to and from those activities.

I also permit, in my absence, any of the foregoing individuals to secure medical treatment or attention for my child, and I consent to my child receiving such treatment or attention or being transported to a medical provider for that purpose.

PAYMENT
VISA, MC, AMEX, DISCOVER
/