Narayangiri Hike Registration | Ardour Basketball

Narayangiri Hike Registration Form

Please fill out the following form.

First name

Last name

Date of Birth

Day

Month

Year

Address

Phone No.

Name of Parent (if minor)

Alternate Phone No.

Are you suffering from a medical condition, illness or injury?

Yes

Have you been hospitalised in the past 12 months?

Yes

If you answered yes to any of the questions above, please supply additional information.

History of medical injuries

https://www.ardourbasketball.org/waiver-narayangiri-hike

I have read the Waiver & Release of Liability Agreement

I, the undersigned, acknowledge that I have no physical impairments or illnesses that I know of that could endanger myself or others. I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for serious or fatal injury of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

I declare that the info I’ve provided is accurate and complete.

Signature

Signature field is empty.