TROJAN

Team Registration Form
TROJAN
HOOPS
To benefit
After School Sports Connection
Trojan Kids Camp and Troy Camp
USC Department Co-SCponsors:
USCRecreationalSports
FOR JUSTICE
3-ON-3 BASKETBALL
TOURNAMENT
OFFICE OF RELIGIOUS LIFE
Fostering a vibrant university community of spiritual reflection and free inquiry
Student Organization Partners:
Troy Camp, AEPi, SigEp, SAM, Pike, ZBT
Community SCponsors:
Lisa & Dov Jeser,
, Icon Plaza
Deborah & Ivan Kallick
Saturday, Feb. 11, 2012
6:30 pm
Lyon Center
Basketball Courts
USCStudentAffairs
IFC
interfraternity council
Contact us at [email protected]
for more information.
Participant Names ID
Email
Grad Year
Major/School
Signature
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SPORTSMANSHIP PLEDGE
By completing this form, all players
accept responsibility for their conduct
at the Trojan Hoops for Justice 3 on 3
Basketball Tournament. The event
reserves the right to disqualify and eject
any individuals and/or teams that behave
in an unsportsmanlike manner.
REGISTRATION FEES
$40 per team before February 1, 2012.
$55 per team after February 1, 2012.
Teams may register no fewer than 3
and no more than 4 players per team.
Registration ends Thursday,
February 8, 2012 at 5:00 pm.
PAYMENTS
Complete both sides of this form and
mail/bring with your payment to:
USC Hillel
3300 S. Hoover St.,
Los Angeles, CA 90007
Attention: Trojan Hoops For Justice
USC WAIVER, RELEASE AND INDEMNITY AGREEMENT
For and in consideration of the University of Southern California permitting the persons identified in the table
For and in consideration of the University of Southern California permitting the persons identified in the table below (each a
“Participant”) to enroll in and participate in the activity described above (“Activity”) each Participant, his/her spouse, assignees,
heirs, guardians, and legal representatives hereby voluntarily indemnify, release from liability, agree to defend and hold harmless
USC and its officers, trustees, employees, agents, representatives, and any department, organization or group affiliated there
with (collectively “USC”) for any accident, injury, illness, death, loss, theft, damage to person or property, or other consequences
suffered by Participant arising or resulting directly or indirectly from the Activity, including but not limited to claims arising from
or related to USC’s negligence and/or products liability, including strict products liability. In the event that Participant is injured,
Participant agrees to assume any financial obligation, either through his/her health insurance, or through some other means, for
any medical costs that he/she incurs. USC assumes no responsibility for any medical expenses, injury, or damage suffered by
Participant in connection with the Activity. IT IS PARTICIPANT’S INTENTION BY SIGNING BELOW TO EXPRESSY ASSUME ALL RISK
OF PERSONAL INJURY, DEATH, ORPROPERTY DAMAGE UPON HIM/HERSELF, TO THE EXCLSUION OF USC, AND TO EXEMPT AND
RELIEVE USC FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH.
By signing this agreement, Participant waives his/her right to bring any legal action now or at any time in the future. By signing
this agreement, Participant waives his/her right to bring any legal action now or at any time in the future to recover compensation
or obtain any other remedy for any injury to him/herself or his/her property or for his/her death, however caused, arising out of
the Activity. Participant further agrees that he/she, his/her spouse, assignees, heirs, guardians, and legal representatives will not
make any claim against, sue or attach the property of USC for any loss or damage resulting from the Activity. Participant is aware
of the potential dangers incidental to the Activity, that this is a release of liability, a waiver of Participant’s legal right to collect
damages in the event of injury, death or property damage, and a contract between USC and Participant, and Participant signs it
of his/her own free will.
Participant expressly agrees that this release is intended to be as broad and inclusive as the State of California will allow and that
if any portion is held invalid, Participant agrees that the balance shall, not withstanding, continue in full legal force and effect.
Eligibility: This certifies that I know and understand the Intramural eligibility rules and have completely checked the eligibility of all players on
my team. If there are any discrepancies, I will assume full responsibility. I understand that failure to comply with these rules will result in
disciplinary action. Participants are required to enroll for Student Health Services and pay the USC Student Health Fee. In addition, participants
are required to purchase student health insurance or to be covered under their personal/parents Health Insurance Policy. All participants’ name
and contact information may be placed on the USC Recreational Sports (Intramural) website.
Captain Signature:___________________________________________________ Date:___________________________________
Enclosed is a check (or cash) in the amount of $__________________ (made payable to USC Hillel)
2 Visa 2 MasterCard #______________________________________ Expiration Date _____________ Sec. Code_________
Name on Account ___________________________________________ Signature ____________________________________
Billing address ___________________________________________________________________________________________
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Contact us at [email protected] for more information.