2024 Basketball Player Release Form

Please let us know if a family member intends to serve as the players buddy.

Please enter the name of the family member who will serve as the players buddy, and be sure to have that family member sign up to volunteer with our volunteer sign up form.

The Children's Center for Communication/Beverly School for the Deaf is a program that takes pride in using technological advances for educational purposes. These endeavors are often used to honor and promote the positive activities that occur on a daily basis. As part of standard practice, CCCBSD will use your child's image for internal media on a regular basis. CCCBSD defines internal media as photos/videos that can be viewed but are never shared externally as a hard copy or electronically (for example: photos in the classroom, classroom videos for shared experiences, photos/videos shown for events or presentations, etc.). Photos and videos are also used for purposes that require external media. CCCBSD defines external media as photos/videos that can be viewed and/or shared as a hard copy or electronically (e.g. Newspaper, annual reports, home notes, classroom photos emailed to families, YouTube, Facebook, etc.) CCCBSD will never post names of students to social media and websites. Only first names are given to newspapers. Parents will be notified if their child's likeness has been photographed for a newspaper article. If you have objections to your child being photographed or videoed for the purpose of external media please specify your objections below. (for example: All photos are fine. No video or All forms of media are okay but do not identify my child by name.)

I give my child permission to take part in the basketball program at CCCBSD. 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 disability, personal injury, or property damage for THE FOLLOWING ENTITIES OR PERSONS: The Children’s Center for Communication/ Beverly School for the Deaf and /or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers; 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 The Children’s Center for Communication/ Beverly School for the Deaf 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 hereby consent to medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. 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. THIS WAIVER WILL BE EFFECTIVE FROM THE SIGNED DATE BELOW AND MOVING FORWARD.

Please describe your external media exceptions here (i.e. all photos are fine, but no video, OR all forms of media are okay, but do not identify my child by name.)

Please fill out the following few questions to identify an emergency contact.

CCCBSD does not take responsibility for images taken of your child by non CCC BSD staff members that may be published as external media (e.g. a photo video with your child's image in the background at school-wide events.). Further, I release CCCBSD, its Board of Trustees, employees, and other representatives from any known liabilities, known or unknown, arising out of the use of these materials.