H.O.R.S.E. Basketball

2025 Bugbee Games Waiver
Please read and acknowledge this waiver

I (the “Participant”) agree with White River Council on Aging, d/b/a Bugbee Senior Center at 262 North Main Street, White River Junction, VT 05001 (the “Activity Provider”) to the following:

1. I am fully aware of the risk inherent in participating in the Activity, and hereby release the Activity Provider, its staff, volunteers, or instructors from any and all liability from injuries, claims, demands, costs, loss of service, expenses and/or damages which may be sustained on account of participation in said program or assorted activities and events. As a matter of caution, the Activity Provider strongly recommends having accident and health insurance in force before taking part in activities.
   
   
2. I understand that I would not be permitted to participate in the Activity unless I sign this waiver.
   
   
3. I do not have any physical limitations, medical ailments, or disabilities that would limit or prevent me from participating.
   
   
4. I hereby give consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this event.
   
   
5. I consent to the use of my photo, video, artwork etc. by the Activity Provider for flyers, presentations, electronic communication, etc. If I do not wish for my image or artwork to be used, I will send this request in writing to [email protected].
   
   
6. I have been given sufficient time to carefully read this Waiver and am voluntarily executing this Waiver.