Ballin’ 4 Burgundy — Over 45 Community Game Registration Submit Registration Print / Save as PDF Little Burgundy • Montreal Ballin’ 4 BurgundyOver 45 Community Game Player Registration “Celebrating the players who paved the way.” DateAugust 23, 2026 LocationLittle Burgundy, Montreal FormatOne Community Exhibition Game RegistrationFree — Donations Accepted EligibilityPlayers age 45 and older 01Player Profile Full Name Date of Birth Age Phone Number Email Address Emergency Contact Name Emergency Contact Phone 02Basketball Profile Preferred Position Guard Forward Center Anywhere Jersey Size Small Medium Large XL XXL Other Do you have any injuries, medical conditions, allergies, or physical limitations we should be aware of? Information is collected for event safety and coordination purposes. 03Support the Movement Participation in the Over 45 Community Game is completely free. Optional donations help Ballin’ 4 Burgundy continue supporting community programming, youth opportunities, sports access, equipment, and future initiatives. Optional Donation Amount Cash E-Transfer Other 04Player Agreement “I acknowledge that participation in the Ballin’ 4 Burgundy Over 45 Community Game is voluntary and that basketball is a physical activity involving inherent risks of injury. I knowingly accept these risks and agree to release Ballin’ 4 Burgundy, its organizers, volunteers, sponsors, officials, contractors, partners, and venue representatives from liability for injury, loss, or damage arising from my participation, except where prohibited by law.I confirm that I am at least 45 years of age, that the information provided on this form is accurate, and that I am physically able to participate. I agree to follow event rules, respect officials, volunteers, spectators, and fellow players, and immediately report any injury or safety concern.” This form is a general event waiver and should be reviewed by the organizer’s legal or insurance professional before official use. MediaConsent I consent to being photographed or recorded during the event and allow Ballin’ 4 Burgundy to use the content for promotional, editorial, archival, website, and social media purposes without compensation. I do not consent to promotional photo or video use. 05Participant Signature By checking this box and typing my full legal name below, I acknowledge that my typed name constitutes my electronic signature. I confirm that I have read, understood, and agree to the Player Agreement and waiver above. Electronic Signature Printed Name Date
