RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY & PARENTAL CONSENT AGREEMENT
AGREEMENT
VILLANOVENCE FC
PARTICIPANT'S NAME (type or print): ___________________________________________
PARTICIPANT'S DATE OF BIRTH (mm/ dd / yyyy): _______________________________
I, the undersigned, in consideration for my voluntary participation in organized soccer, do hereby willfully acknowledge that my signature below attests to my understanding and agreement that:
Soccer is a physical, contact sport that involves the risk of injury, and dangers of serious bodily harm, including permanent disability, paralysis, and death. I voluntarily accept and assume all risks and hazards associated with my participation/playing in the sport (Soccer) with the above-named soccer organization. I acknowledge these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the condition in which the Activity takes place, or the negligence of the Releases named below; there may be other risk and social and economic losses either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation or that of the minor in the Activity (Practices/Training/Games).
I am in proper physical condition to participate in soccer practices and games and have no illness, disease or existing injury, or physical defect that would be aggravated by my participation. I will inform my coach if this status changes. I further acknowledge that this risk may involve loss or damage to me or my property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I have a current medical consent form in force.
The VILLANOVENCE FC does not have personal injury insurance that covers my participation. Therefore, I should have a current, active, personal injury insurance policy in force, which covers my participation. Under any condition, I am responsible for any and all medical expenses arising from my participation, both in practices and games and while traveling to and from these events, even when I request transportation to and from these events.
I have the right and responsibility to inspect the equipment and facilities prior to events and, if I believe that anything may be unsafe, I will advise the coach or supervisor of the condition and may refuse to participate. Participation assumes consent.
I authorize my photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising), television, video, social media, or radio coverage, without compensation.
I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue, the VILLANOVENCE FC ACADEMY, their associated directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors and advertisers, and other agents, estates or executors, from any and all liability incurred in the conduct of, and my participation in, their soccer programs and I further agree that if, despite this Agreement, I, or anyone on my behalf, makes claim against any of the Releases, I will indemnify, save and hold harmless each of the Releases from any litigation expenses, attorney fees, loss, liability, damage, or any costs which may incur as the result of such claim. This also includes owners, lessors, and lessees of premises, tournament organizers, municipalities, government agencies, successors, heirs, and assigns.
I have completely read this document and fully understand its contents. I acknowledge that I have given up substantial rights by accepting this document and that I do so voluntarily, I signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability 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 full force and effect.
My signature attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns.
For those individuals eighteen (18) years of age and older:
________________________________ ___________________________________ ____________________
Participant's Name (Print) Participant's Signature Date Signed
For those individuals under the age of eighteen (18) years (minor):
As the parent and natural guardian or legal guardian of the participant, I hereby agree to the foregoing Waiver of Liability and Release for, and on behalf of, the participant (player/minor) named above. I hereby bind myself, the minor, and all other assigns to the terms of the Waiver of Liability and Release. I represent and certify that I have the legal capacity and the authority to act for, and on behalf of, the minor in the execution of this Waiver of Liability and Release.
___________________________________ ____________________________________ ____________________
Parent/Guardian Name (Print) Parent/Guardian Signature Date Signed