Bloomfield Home & School Basketball: Safety

Safety and Insurance
Below is a sample permission form.

Although all precautions for safety are taken, I am aware that as in all sporting activities , there is a risk of injury. Furthermore, I am aware that my child is not automatically covered under accident insurance through the Home and School Association. As such, I accept all responsibility for injuries that may be sustained by my child during the Home and School Basketball Program. If any injury should occur, I agree to hold harmless the Home and School Association, any of its officers, team coaches or other individuals, parents and volunteers associated with this program liable for such. I also attest to the fact that no medical condition exists that would prohibit my son/daughter from participating in this program.

Note: If you do not have medical coverage you can purchase insurance from Bollinger. Please be advised, you must buy the 24/7 coverage as this is a Home and Schhol function NOT a Board of Ed. League.








I, the Parent/Guardian of ___________________________________________,
have read the above statement and hereby authorize his/her participation in the Bloomfield Home and School Basketball Program.


Players Name:________________________________________


Parent/Guardian Signature:__________________________________      Date:___________