Download Waiver

Indoor Soccer Center

Player Waiver

Use 1 waiver if same parent signing for more than one player

Player’s

Name_______________________________________________________________

Parent’s

Name_______________________________________________________________ Leave blank if

player is 19 years of age or older as of date of league play starting

Team Name _____________

_________________________________________

Coach’s

Name_______________________________________________________________

Email Address

Home Phone _____________ Cell Phone _____________ Emergency phone

Age __________ Male ____________ Female _____________

____

Participant Release of Liability

-

Read before signing

In consideration of being allowed to participate in any way in the Indoor Soccer Center

Fall/Winter indoor soccer league running from

______________________to __________________

___

.

I, _____________________

______, the undersigned, acknowledge, appreciate, and agree

that:

1

The risk of personal injury from the activities involved in this program is significant, including the

potential for permanent paralysis and death. While particular rules, equipment, and

personal discipline

may reduce the risk, the risk of serious injury does exist; and,

2

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS

, both known and unknown, EVEN IF

ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for

me

participation; and,

3

I willingly agree to comply with the stated and customary terms and conditions for participation. If

however I observe any unusual significant hazard during my presence or participation I will remove myself

or my child from participation and bring such to

the attention of the nearest official immediately; and,

4.

I, for myself on behalf of my heirs, assigns, personal representatives and next of kind,

HEREBY

RELEASE, INDEMNIFY, AND HOLD HARMLESS, Indoor Soccer Center

, their officers, officials,

employees, s

ponsoring agencies, and advertisers, and owners and lessors of premises used to conduct

the event (“Releases”), with RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or

damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEA

SES OR

OTHERWISE, to the fullest extent permitted by law.

I HAVE

READ THIS RELEASE OF LIABILITY/ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND

ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, & SIGN IT

FREELY AND VOLUNTARILY WI

THOUT ANY INDUCEMENT.

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE

(UNDER AGE 18 AT TIME OF

REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and

agree to his/her release as pr

ovided above of all the Releases, and for

myself, my heirs, assigns, and

next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liabilities

incident to my minor child’s involvement or participation in these programs a

s provided above,

EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES, to the fullest extent permitted by the law.

X _______________________________ date___________ Player/Parent/Guardian

Signature

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