Weekday/Sunday Training Only — Prodigy Athletic Institute

Apply for Weekday/Sunday Training Only

(Middle School, High School, College)

THIS FORM CANNOT BE USED FOR TRAVEL BALL.
Required for any student-athlete requesting training sessions under the strict instruction and coordination with Coach Cameron Murray. It must be renewed every school year. Official training sites are Calfornia School of the Arts (Duarte), Fierce Athletics Facility (R. Cucamonga), and Duarte High School.

Student-Athlete Name

First Name

Last Name

Date of Birth

YYYY

Grade/Year

Name of School/Team/Adult Program (if applicable)

Home Address

City

Zip Code

Student-Athlete's Cell Phone

Parent/Legal Guardian (over 18 type "NA")

Any pre-existing injuries (if no, type "NA")

COVID-19 DISCLAIMER You have the right to workout/tryout/practice in or at a safe, clean, and welcoming environment. Social distancing will be used whenever possible. If, at any time, you feel uncomfortable, please let a coach know. To prevent the spread of COVID-19 and reduce the potential risk of exposure, please follow the protocols wherever Prodigy events are being conducted. Attendance will be modified based on the coaching staff, location, venue, and protocol requirements. RELEASE & WAIVER I/we hereby attest that I/we are fully cognizant of the ASSUMED risks involved in the sport of basketball. I/we voluntarily assume and agree to abide by the published and spoken rules of this organization, at all times, regardless of time and location, and for the entire length of student-athlete's participation. GOOD HEALTH I/we acknowledge and fully understand that my/our student-athlete will be engaging in a contact sport that might result in serious injury or death, due to or not due to my/our student-athlete's actions. I/we further attest that the student-athlete does not suffer from any known heart condition, is in good health, and can handle the contact associated with the sport. In the event of any injury, our certified trainer or a qualified staff member will provide immediate examination and/or treatment. If I/we cannot be contacted, the emergency contact will be called, and/or be directed to transport the student-athlete by car or ambulance to the nearest medical facility (CED section 11710). ASSUMPTION OF RISK I/we assume all liabilities, and release, waiver, discharge the right to pursue and legal (past,present,or future) against the organization, administrators, school districts, schools, school staff, employees, organizers, volunteers, coaches, incidental or direct liability connected with the student-athlete's participation. PAYMENT This is a required, non-negotiable document and valid only 1 year from submission. Payments are due PRIOR TO THE START OF EVERY SESSION (cash, check, online incl fee). There are no refunds or credits due to absences, illnesses, or vacations. This does not replace an official travel ball application. Non-payment means non-participation. Failure to comply or behavior detrimental to instruction by any individual associated with the individual listed above will result in immediate dismissal without refund or credit. LEGAL Prodigy Athletic Institute is a legally insured and nationally recognized institution. The use of our legal name (Prodigy Athletic Institute and in any form) and/or reproduction of that name is strictly prohibited.

Please select one

I am the parent/legal guardian of the individual name above

I am age 18 or older

By typing my/our name (s), I/we consent and fully understand the information listed above: