Participant's name *

First Name

Last Name

Participant's date of birth *

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DD

YYYY

Parent/Guardian's name *

First Name

Last Name

Phone # *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Today's date *

MM

DD

YYYY

Improve Soccer Waiver *

1. The risks of injury and illness (ex: communicable diseases such as influenza, and COVID-19 and other) from the activities involved in this program are possible, including the potential for injury and in extreme cases the possibility of death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I or my guardian observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4. I, HEREBY RELEASE AND HOLD HARMLESS Prosedale and all their staff coaches their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. This is to certify that I, as parent/guardian with legal responsibility for this participant(s), have read and explained the provisions in this waiver/release to my child(s)/ward including the risks of the activity and his/her/their responsibilities for adhering to the rules and regulations. Furthermore, my child(s)/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child(s)/ward do consent and agree to his/her/their release provided above for all the Releasees and myself, my spouse, and child(s)/ward do release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s(children’s)/ward’s involvement or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. Improve Soccer is a Subsidiary of Prosedale Soccer Academy Inc.

I agree and am a parent or guardian of the named participant(s)