HOOP IT UP Youth Basketball League EL CAMINO YMCA

VENIR AJUGAR JUNTOSLiga de baloncesto para JovenesEL CAMINO YMCALiga de baloncesto de los aros YMCA enseña losfundamentos del baloncesto y ofrece a los niños unaexperiencia de equipo organizada por función positivade los adultos modelos. Los participantes a mejorar sushabilidades de baloncesto con la práctica y las habilidadessociales a través del trabajo en equipo.Fechas 18 de Enero – 15 de MarzoPractica – 1 hora Lunes-Viernes(Practica empieza 6 de Enero)Juegos – 1 hora SabadosGrados Kinder – 8localidad GimnasioPrecio Miembros de Facilidad – $135Miebros del Programa – $165Inscribirse La inscripcion para baloncesto parajovenes termina 1 de DeciembreContacto Jeff Maier o 650 429 1330jmaier@ymcasv.orgAsistencia Financiera DisponibleNo afiliado con el Distrito Escolar Whisman MontañaEL CAMINO YMCA 2400 Grant Road, Mountain View CA 94040650 969 9622 | elcaminoymca.org

EL CAMINO YMCAYouth Basketball League RegistrationJANUARY 6 - MARCH 15, 2014GRADES K-8, CO-ED LEAGUE¨ $135 Facility Members¨ $165 Program Members*Registration ends Sunday, December 1, 2013 ($20 late fee)*A current $45 program membership fee per year is required for registration.PRACTICE1 Hour onMon-FriGAMES1 Houron SatPARTICIPANT INFORMATIONFirst NameLast NameDate of BirthGradeGenderSchoolLevel of Play¨ beginner ¨ intermediate ¨ advancedBuddy RequestNOTE: Buddy requests are limited to one request per player, are notguaranteed, and must be mutually requested by both parties.PARENT / GUARDIAN INFORMATIONFirst NameLast NameHome AddressCityStateZipHome PhoneCell PhoneEmailI WOULD LIKE TO CHANGE A LIFE ANDSPONSOR A CHILD¨ $10 ¨ $25 ¨ $50 ¨ $100EL CAMINO YMCA 2400 Grant Road, Mountain View CA 94040650 969 6922 | elcaminoymca.orgYES, I AM INTERESTED IN COACHINGMY CHILD’S TEAM:¨ head coachI’m Available to CoachDayTimeEMERGENCY CONTACTFirst NameLast NameCellRelationshipBY SIGNING BELOW, I UNDERSTANDTHE FOLLOWING:• a $20 processing fee may be deducted from therefund amount• transfers are based upon availability• cancellations must be made within two weeks(10 business days) of the program start date• programs cancelled after the start date will notbe refunded more than 50%• deposits (if any) are non-refundable• program memberships are non-refundableBy signing below, I understand that payment is duein full at the time of registration (including waitlistregistration).If we cannot process your waitlist application, you will berefunded 100%.SignatureDateCredit Card NumberExp. DateKeep my Credit Card on file ¨ yes ¨ noStaff NameDate

YMCA OF SILICON VALLEYRelease and Waiver of Liability and Indemnity AgreementIN CONSIDERATION of being permitted to utilize the facilities, services and programs of the YMCA (or for my children to so participate)for any purpose, including, but not limited to observation or use of facilities or equipment, or participation in any off-site programaffiliated with the YMCA, the undersigned, for himself or herself and such participating children and any personal representatives,heirs, and next of kin, hereby acknowledges, agrees and represents that he or she has, or immediately upon entering or participatingwill, inspect and carefully consider such premises and facilities or the affiliated program. It is further warranted that such entry into theYMCA for observation or use of any facilities or equipment or participation in such affiliated program constitutes an acknowledgmentthat such premises and all facilities and equipment thereon and such affiliated program have been inspected and carefully consideredand that the undersigned finds and accepts same as being safe and reasonably suited for the purpose of such observation, use orparticipation by the undersigned and such children.IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER THE YMCA FOR ANY PURPOSE INCLUDING, BUT NOT LIMITEDTO OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY OFF-SITE PROGRAM AFFILIATED WITH THEYMCA, THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:1. THE UNDERSIGNED, ON HIS OR HER BEHALF AND BEHALF OF SUCH CHILDREN, HEREBY RELEASES, WAIVES, DISCHARGESAND COVENANTS NOT TO SUE the YMCA, its directors, officers, employees, and agents (hereinafter referred to as“releases”) from all liability to the undersigned or such children and all his personal representatives, assigns, heirs, andnext of kin for any loss or damage, and any claim or demands therefore on account of injury to the person or propertyor resulting in death of the undersigned, whether caused by the negligence of the releases or otherwise while theundersigned or such children is in, upon, or about the premises or any facilities or equipment therein or participating inany program affiliated with the YMCA.2. THE UNDERSIGNED HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS the releases and each of themfrom any loss, liability, damage or cost they may incur due to the presence of the undersigned or such children in, uponor about the YMCA premises or in any way observing or using any facilities or equipment of the YMCA or participatingin any program affiliated with the YMCA whether caused by the negligence of the releases or otherwise.3. THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR AND RISK OF BODILY INJURY, DEATH OR PROPERTYDAMAGE to the undersigned or such children due to negligence of releases or in, about or upon the premises of theYMCA and/or while using the premises or any facilities or equipment thereon or otherwise while participating in anyprogram affiliated with the YMCA.THE UNDERSIGNED further expressly agrees that the foregoing RELEASE, WAIVER AND INDEMNITY AGREEMENT is intended to beas broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreedthat the balance shall, notwithstanding, continue in full legal force and effect.THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT,and further agrees that no oral representations, statements or inducement apart from the foregoing written agreement havebeen made.I HAVE READ THIS RELEASE.Print Name of Applicant/ParentPrint Name of Child in ProgramSignature of Applicant/Parent Date Print Name of Child in ProgramPrint Name of Applicant/ParentPrint Name of Child in ProgramSignature of Applicant/Parent Date Print Name of Child in Program

YMCA OF SILICON VALLEYPhoto and Video/Audio Recording ReleaseI am 18 years of age or older and, if not, my Mother/Father/Legal Guardian has also signed below.For my participation in activities to be conducted by YMCA of Silicon Valley, I hereby give my permission and consent,now and for all time, to YMCA of Silicon Valley, the National Council of Young Men’s Christian Associations of theUnited States of America (YMCA of the USA) and third parties collaborating with YMCA of Silicon Valley and/or YMCAof the USA to make, reproduce, edit, broadcast or rebroadcast any video film, footage, sound track recordings andphoto reproductions of me and/or my narrative account of my experience at YMCA of Silicon Valley, for publication,display, sale or exhibition thereof in promotions, advertising and legitimate business uses without any compensationto, and/or claim, by me. I may, or may not be, identified in such reproductions; however, I shall not be stated byname to have endorsed any particular commercial products or commercial services.I further agree to the following:- Any video film, footage, sound track recordings, and photo reproductions of me and/or my narrative account ofmy experience at YMCA of Silicon Valley, I authorize, according to this Release, shall belong to YMCA of SiliconValley, YMCA of the USA and third parties collaborating with YMCA of Silicon Valley and/or YMCA of the USA.Therefore, they will have full right of disposition of any video film, footage, sound track recordings and photoreproductions of me and/or my narrative account of my experience YMCA of Silicon Valley;- Any video film, footage, sound track recordings and photo reproductions of me and/or my narrative account ofmy experience YMCA of Silicon Valley will not be subject to any obligation of confidentiality and may be sharedwith and used by YMCA of Silicon Valley, YMCA of the USA and third parties collaborating with YMCA of SiliconValley and/or YMCA of the USA;- YMCA of Silicon Valley, YMCA of the USA and third parties collaborating with YMCA of Silicon Valley and/or YMCAof the USA shall not be liable for any use or disclosure to a third party of any video film, footage, sound trackrecordings and photo reproductions of me and/or my narrative account of my experience at YMCA of SiliconValley; and- YMCA of Silicon Valley, YMCA of the USA and third parties collaborating with YMCA of Silicon Valley and/orYMCA of the USA shall exclusively own all known or later existing rights to worldwide and shall be entitled tothe unrestricted use any video film, footage, sound track recordings and photo reproductions of me and/or mynarrative account of my experience at YMCA of Silicon Valley for any purpose without compensation to me.I agree that my consent and this release are irrevocable. I hereby release and discharge YMCA of Silicon Valley, YMCA ofthe USA and third parties collaborating with YMCA of Silicon Valley and/or YMCA of the USA from any and all claims inconnection with the uses and reproductions of any video film, footage, sound track recordings and photo reproductionsof me and/or my narrative account of my experience YMCA of Silicon Valley as described herein.Signature Print Name DateAddressAgeI am the Mother/Father/Legal Guardian ofcontained herein, I hereby consent to the foregoing on behalf of my minor child.(child’s name). For the considerationSignature of Mother/Father/Legal GuardianDate