Online Payment & Registration Form

Credit Card Payment or make checks payable to TJD Sports Academy, LLC.

Pay Here – Credit Card

Participant Name *

Parent/Guardian Name

If under 18 please provide the parent/guardian name

Phone Number *

Email *

Program *

Please provide the name of the program/class you are signing up for

Medical Conditions *

General Release: TJD Sports recommends the disclosure of relevant health information. Unless TJD Sports is notified IN WRITING, staff will be forwarded all information on the registration form, including health conditions.

Additional Comments

General Waiver – Participant Signature *

I assume all of the foregoing risks and accept personal responsibility for any injury, disability or death and any damages, whether social or economic, and agree to release, waive, discharge and indemnify TJD Sports and its employees, agents and facilities from any and all liability to the undersigned, his or her heirs and next of kin, for any and all claims, demands, suits, expenses, losses, injuries or damages caused or alleged to have been caused been caused by Releases. Parents/Guardian signature allowing participation & waiving claims that may result from injury due to basketball activity.

Covid-19 Waiver Signature *

Covid-19 Waiver Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. TJD Sports Academy has put in place preventative measures to reduce the spread of COVID-19; however, we cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending any TJD Sports Academy program could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending any TJD Sports Academy and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at any TJD Sports Academy program may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at any TJD Sports Academy program. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Club, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating there to. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of any TJD Sports Academy program, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any TJD Sports Academy program.