PLANT SOCCER CAMP PARENT /GUARDIAN CONSENT, ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
I hereby assume all of the risks of participating in this Soccer Camp, including by way of example and not limitation, risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this Soccer Camp. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the organizers of the Soccer Camp in which I may participate and that it will govern my actions and responsibilities at said Football Camp.
In consideration of my application and permitting me to participate in this Soccer Camp, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability rising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this Camp, the following entities or persons: Mike Miranda Soccer Camp, Plant High School Soccer, Panther Pitch Club, Inc, Michael Miranda, H. B. Plant High School, and/or their coaches, agents, representatives or volunteers.
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this Soccer Camp, whether caused by negligence or otherwise.
I acknowledge that this soccer camp may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, and lack of hydration.
I consent that Panther Soccer Camps and/or their coaches, agents, representatives, or volunteers may take photographs or digital recordings of me participating in this event and use these in any and all media for training and/or promotional purposes. I further consent that my identity may be revealed there in or by description text or commentary. I waive any rights, claims or interest and I understand that there will be no financial or other renumeration.
The accident waiver, release of liability and the image release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL.
PARENT/GUARDIAN PLEASE SIGN BELOW
