Summer Recreation Basketball Program YOUNG ADULTS, 14-21 YEARS 2023 SEASONPICK UP STYLEYoung Adults, Ages 14-21 Dates: Thursdays June 8 - July 20, 2023, 7:00-9:00 PMMust register by Friday June 2, 2023 Fee: No Fee in 2023 Name * Address * Town * Phone Number * Email * Level of Experience * Beginner (little to no experience) Intermediate Advanced (Varsity/College) Signature * I, the undersigned, do hereby consent to my participation in voluntary or recreation programs of the Town of Sturbridge. I also agree to forever release the Town of Sturbridge, and all their employees, agents, board members, volunteers and any and all individuals and organizations assisting or participating in any voluntary or recreation programs of the Town (“the Releasees”) from any and all claims, rights of action that may have risen in the past, or may arise in the future, directly or indirectly, from personal injuries to myself or property damage resulting from my participation in the Town of Sturbridge voluntary activities or recreation programs. I also promise, to indemnify, defend, and hold harmless the Releasees against any and all legal claims and proceedings of any description that may have been asserted in the past, or may be asserted in the future, directly or indirectly, arising from personal injuries to myself or property damage resulting from participation in the Town of Sturbridge voluntary activities or recreation programs. I further affirm that I have read this Consent and Release Form and that I understand the contents of this Form. I understand that my participation is voluntary and that I am free to choose not to participate in said programs. By signing this form, I affirm that I have decided to participate in the Town as a volunteer or in its recreation programs with full knowledge that the Releasees will not be liable to anyone for personal injuries and property damage that I may suffer in voluntary activities Sturbridge or recreation programs. Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025202620272028202920302031203220332034203520362037203820392040204120422043204420452046 Parent Signature (if under 18) * Leave this field blank