Register for RCCS Score4RCCS 2021

Registration Information

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip / Postal: *

Country: *

Phone Number: *

Additional Phone Number:

Email Address: *

Date of Birth: *

Jersey Size: *

Emergency Contact Information

Emergency Contact: *

Emergency Phone: *

Fundraising Commitment

Player Fundraising goal of $600.

All Star Fundraising goal of $1,000.

MVP Fundraising goal of $1,800.

Hall of Famer Fundraising goal of $2,500.

Account Information

Custom URL:* Create your custom url to use for your personal fundraising page (This will also be your account username)

https://www.rayze.it/score4rccs2021/

Sign in with Google or choose a password. You will need it to view / edit your personal web page, and see who has sponsored you for this event.

Password: *

Re-Type Password: *

Additional Information optional

Additional Comments:

How Did You Hear About Us?

Waiver and Release

HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH RCCS, including by way of example and not limitation, any and all injuries that may occur.  I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.  I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.   In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:   (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES RCCS and Score4RCCS and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;  (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.  I acknowledge that RCCS and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.  I acknowledge that this Basketball Tournament and all activities may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. By participating in this   tournament, I assume all risks known or unknown.  I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.  I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.   I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

I accept the above waiver and release