Emergency Authorization
I, the parent or legal guardian of the above named player, a minor (Player) hereby authorize each of the coaches, team parents, and/or other officials of Pomona City Football Club Inc. act as my agents in the capacity of activity supervisors and vehicle drivers, and I authorize each of them as well as the above-identified Emergency Contact to consent to medical, surgical or dental examination and/or treatment.
I HAVE READ THE ABOVE EMERGENCY AUTHORIZATION, AND THE DISCLAIMER, ASSUMPTION OF RISK WAIVER, AND THE ACKNOWLEDGEMENT AND CONSENT AGREEMENTS PRINTED ON THE NEXT PAGE, FULLY UNDERSTAND THE TERMS OF EACH, UNDERSTAND THAT I AND PLAYER HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS FORM AND AGREEING TO THESE TERMS, AND I SIGN THIS FORM FOR MYSELF AND ON BEHALF OF PLAYER AND AGREE TO THESE TERMS FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT.
Participant Release Waiver
DISCLAIMER, ASSUMPTION OF RISK AND WAIVER AND CONSENT AGREEMENTS
I warrant and acknowledge that I am the parent or legal guardian of the player named on this application, a minor (Player), and on behalf of myself, Player and our heirs, assigns and next to kin, I hereby enter into the following agreements IN CONSIDERATION OF Player’s being able to participate in any way at practices, games or other activities (EVENTS) sanctioned by Pomona City Football Club Inc.
DISCLAIMER, ASSUMPTION OF RISK AND WAIVER: I acknowledge that participation in soccer necessarily involves travel, play in adverse field conditions, contact with considerable force, and risk of severe, permanent physical injury including bruises, scrapes, stained, sprained or torn muscles, tendons or ligaments, broken bones, dislocation of joints, concussion, brain damage, nerve and spinal cord injury, paralysis and death. I WILLINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS. I willingly and voluntarily agree to comply with stated and customary terms and conditions for participation and, if Player of I observe any concern in Player’s readiness for participation in EVENTS, I will remove him/her from participation and bring such concern to the attention of the nearest official immediately and also of the coaches as soon as possible thereafter.
I HEREBY RELEASE, DISCHARGE AND AGREE TO HOLD HARMLESS, to the fullest extent permitted by law, Pomona City Football Club Inc. its players, employees, volunteers, officials, sponsors and other representatives and any and all owners, lessors, lessees or other persons of entities allowing, permitting or authorizing the use of facilities by Pomona City Football Club Inc. and agents, employees, officers and directors of said persons or entities (RELEASES) from any and all claims, demands, costs, expenses and compensation arising out of or in any way related to an injury or other damage that may result to said participant or to members of my family or my household or individuals I invite or for whom I am otherwise responsible while participating in or present at any of the EVENTS, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
I further acknowledge and accept that this Disclaimer, Assumption of Risk and Waiver is intended to be as broad and inclusive as permitted by the laws of the state in which we live and agree that if any portion of this Disclaimer, Assumption of Risk and Waiver is deemed to be invalid, the remainder will continue in full legal force and effect.
ACKNOWLEDGEMENT AND CONSENT: For both internal and external use, I acknowledge that Pomona City Football Club Inc. may compile and use soccer photographs and videos of Player and use them for print, social media and website promotion. I consent to such uses and hereby waive all rights to approval and compensation.
