Date: Saturday, April 6, 2013

Time: Ages 12 & up 9:00 am -­ 12:00 pm 1:00 pm -­ 4:00 pmLocation: McKenzie High School Gym

23292 Highway 22

McKenzie, TN 38201

Cost: $70.00

Space is limited;; sign up today! Clinic features:

Contact:

731-­352-­2133

Facebook.com/PureSweat

Twitter.com/PureSweat

YouTube.com/PureSweatBasketball

www.PureSweatBasketball.com

Drew Hanlen Bio:

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Pure Sweat Basketball’sElite Skill Development ClinicSponsored by Drew Hanlen/Pure Sweat and Gateway Basketball Club

John Wall David Lee

www.PureSweatBasketball.com

Player Name: M F

Birthdate: Grade:

Address:

City: ST: Zip:

Home Phone:

Day / Cell Phone:

E-mail:

School attending:

Parent / Guardian 1:

Day / Cell Phone:

E-mail:

Parent / Guardian 2:

Day / Cell Phone:

E-mail:

For more information, or to register, please contact:John Wilkins at wilkinsj4@k12tn.net or call 731-352-2133

Pure Sweat Basketball Waiver:In enrolling in a Pure Sweat Basketball event, participant understands that he/she attending the event does so at his/her own risk. Pure Sweat Basketball and its own-ers, employees or agents, shall not be liable for any damage whatsoever arising from any personal injury or property loss sustained by participant with his/her family in or about any programs on the premises. Participants and parents assume full respon-sibility for all injuries and damages which occur in or about any programs on the premises, He/She does hereby fully and forever release discharged hold harmless Pure Sweat Basketball, all associated facilities and its owner, employees, and agents from any and all claims, demands, damages or rights of action, present or future resulting from any person’s participation in any programs or use of the facility. In addition, he/she agree(s) to follow the rules of conduct and play set by Pure Sweat Basketball. Failure to do so may result in suspension from participation.

I hereby authorize Pure Sweat Basketball and it’s representatives to act for me accord-ing to his/her best judgment in an emergency requiringmedical attention. I know

participate in any Pure Sweat Basketball event. I will be responsible for all medical charges, along with any other charges, in connection with his/her attendance of this activity. I agree to abide by the rules and regulations set by Pure Sweat Basketball.

I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional release of all liabilty to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in

Printed Name of Player (Parent / Guardian if under the age of 18)

Signature of Player (Parent / Guardian if under the age of 18) Date

Additional Notes:

Pure Sweat Basketball’sElite Skill Development ClinicSponsored by Drew Hanlen/Pure Sweat and Gateway Basketball Club