Permission & Release Form
IN CONSIDERATION of being permitted to participate in the basketball game(s), event(s) and other activit(y/ies) scheduled to take place in connection with the 2019 Jr. NBA Philippines program (collectively, the “Events”), the undersigned, on behalf of myself, my participant child or ward (if applicable) (the “Participant”), and Participant’s personal representatives, heirs, assigns, and next of kin, hereby:
1. irrevocably grant permission to each of the Released Entities (as defined below) to utilize my name, voice, statements, photographs, images, likeness, actions at the Events and/or my biographical data in any live or recorded form (including, but not limited to, any form of video display or other transmission or reproduction), in whole or in part, for promotional, commercial or any other purpose, in perpetuity worldwide in any media whether now known or hereafter created without any additional consideration;
2. (a) acknowledge that my participation in the Events involves risk of serious bodily injury, death, property damage and/or other harm which might result not only from the my actions, inactions, or negligence, but also from the actions, inactions or negligence of others, the conditions of the premises or of any equipment used and that there may be other risks not known or reasonably foreseeable at this time; and (b) accept sole responsibility for all of the hazards and risks to my property associated with or related to my participation in the Events and for any damage or injury that I may cause to others;
3. (a) to the extent permitted by applicable law, release, waive and forever discharge any and all claims of damages or causes of action, including but not limited to, death, personal injury or loss or damage to property, which I or any of my representatives, heirs, next of kin or assignees (“Participant Representatives”) may have or which may hereinafter accrue to the myself or the Participant Representatives as a result of my participation in the Events or otherwise and which may be asserted by the myself or the Participant Representatives against NBA Philippines, Inc., NBA Asia Limited, NBA Entertainment, a division of NBA Properties, Inc., NBA Properties, Inc. (“NBAP”), the National Basketball Association and its member teams, the NBA Development League, LLC and its teams, WNBA Enterprises, LLC, the Women’s National Basketball Association and its member teams, and each of their respective affiliates, administrators, agents, coaches, officers, directors and employees, other participants, sponsoring agencies, sponsors, advertisers, designees, licensees and if applicable, owners and lessees of premises used in connection with the Events (collectively, the “Released Entities”), whether caused by the acts, omissions or negligence of the Released Entities or by any other person or entity and (b) agree to indemnify and save and hold harmless the Released Entities and each of them from any loss, liability, damage or cost they may incur due to my participation in or otherwise in connection with the Events, whether caused by the negligence of any of the Released Entities or otherwise;
4. in the event of illness or injury, (a) consent to whatever x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care and transportation considered necessary in the best judgment of the attending physician, surgeon, or dentist performed under the supervision of a member of the medical or dental staff of the hospital or facility furnishing medical or dental services and (b) acknowledge that no medical or dental coverage for the Participant will be provided by the Released Entities;
5. understand and agree that (a) my refusal to accept any prize from any Event or other activity shall constitute a forfeiture of that prize and shall release the Released Entities from any and all obligations in connection with such prize; (b) I am responsible for and shall pay all state and federal or other taxes as required for by applicable law on any and all cash and/or prizes I win; (c) I agree and acknowledges that the Released Entities reserve the right to withhold any payable taxes from any and all cash or prizes I win to make payments to the relevant tax authorities as required by applicable law from time to time; (d) I will indemnify and hold the Released Entities harmless against any liability for any such taxes and agree that any of the Released Entities may deduct or require payment of any such tax before delivery of a prize; and (e) any travel undertaken by myself in connection with my acceptance or use of any prize shall be taken at my sole risk.
FURTHERMORE, I FULLY ACKNOWLEDGE, APPRECIATE AND UNDERSTAND THE RISK THAT MY PARTICIPATION IN ANY CONTEST, ACCEPTANCE OF ANY PRIZES AND/OR NBAP’S USE OF THE MATERIALS COULD AFFECT ANY HIGH SCHOOL OR INTERCOLLEGIATE ATHLETIC ELIGIBILITY THAT I MAY HAVE, AND I FULLY ASSUME SUCH RISK AND RELEASE THE RELEASED ENTITIES FROM ANY LIABILITY IN CONNECTION WITH ANY SUCH FAILURE TO BE ELIGIBLE FOR HIGH SCHOOL OR INTERCOLLEGIATE ATHLETIC COMPETITION;
6. acknowledge that the Released Entities are relying on the grant of rights contained herein; and
7. expressly agree that this Permission and Release Form is intended to be as broad and inclusive as is permitted by all applicable laws and that if any portion hereof is held invalid, it is agreed that the balance shall nonetheless continue in full legal force and effect.
8. agree that this Permission and Release Form is governed by, and shall be construed and enforced in accordance with, the laws of the State of New York, United States of America, excluding its choice of law principles. Any claim arising out of, relating to, or in connection with this Permission and Release Form, including any question regarding its existence, validity, or termination, and any question as to whether a particular dispute is arbitrable hereunder, shall be referred to and finally resolved by binding arbitration administered by the International Court of Arbitration in accordance with its International Arbitration Rules (“Rules”) by three arbitrators appointed in accordance with such Rules, with the two co-arbitrators having 30 days from the appointment of the second arbitrator to nominate the chair. The place of arbitration shall be New York County, New York, and the language to be used in the arbitral proceedings shall be English. The arbitrators shall award to the prevailing party its costs, including its attorneys’ fees, incurred in connection with the arbitration. Judgment upon the award may be entered by any court having jurisdiction thereof. The parties waive irrevocably their right to any form of appeal, review or recourse to any judicial authority, insofar as such waiver may be validly made, with respect to any award of the arbitrators, including interim or partial awards, and including with respect to questions of law. Participant hereby waives in any such arbitration and in any Ancillary Proceedings (as defined below) any defense of lack of personal jurisdiction or forum non convenience or other similar doctrine The parties hereby consent to the jurisdiction of the courts sitting in New York County, New York, in connection with any legal proceedings concerning or arising out of any such arbitration (including proceedings to compel arbitration, stay litigation, issue interim measures of protection including attachments, confirm, recognize or enforce an arbitral award, or enforce a court judgment issued on an arbitral award) (“Ancillary Proceedings”) and agree that such courts shall award to the prevailing party its costs, including its attorneys’ fees, incurred in connection with such Ancillary Proceeding.
I HAVE READ AND VOLUNTARILY SIGN THIS PERMISSION AND RELEASE FORM, and further agree that no oral representations, statements or inducement contrary to anything contained herein have been made by NBAP or any of its employees or agents. In the event of any conflict between the English language version of this form and any translation thereof, the English language version shall prevail.
AGREED TO AND ACCEPTED: Indicate (check the box) if Participant is a: ☐ Coach or ☐ Player
Full Name of Participant: ___________________________ Date of Birth:_____________
Sex: ☐ Male ☐ Female
First Name
Last Name
MM/DD/YYYY
Mobile Number of Participant: ________________________________
* Email Address of Participant: ____________________________
*Full Name of Adult (Parent/Guardian): ______________________________
* Email Address of Parent/Guardian: ________________________
First Name Last Name : __________________________
Mobile Number of Parent/Guardian: ____________________________ *required if Participant is a minor.
Country:___________________
Postal / ZIP Code:___________________
Participant’s School:_________________________________
I confirm and represent to NBA Properties, Inc. that I am the parent or legal guardian exercising parental authority over the Participant and I freely and willingly AGREE and ACCEPT the terms and conditions of the Permission and Release Form for and on behalf of the Participant. By signing below, I hereby represent that I have accessed, read and agree to the Jr. NBA Indonesia - Program Terms and Conditions located at https://jrnba.asia/id_EN/ Signature of Participant/
Participant’s Parent or Guardian: __________________________
Date: ________________________________________
FOR NBAP USE ONLY NAME OF EVENT: _________________________________________
Signature of NBA Properties, Inc. on behalf of the Released Entities Name: __________________________________________________
Position/Title: ________________________________________