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:
My player status will be kept in good standing. I will not compromise myself in such a way as to do
harm to the league or tournament, knowing that players may be dismissed from participation, with
possible loss of payment or dues, for violent conduct or unsportsmanlike behavior on or off the field of
play. I agree to pay for any and all damages to any property or indemnities caused by me willfully,
negligently, or otherwise.
Soccer is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards
associated with my participation in the sport. 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. I will wear shin guards,
properly-fitted and appropriate shoes, and other protective equipment (e.g., mouth-pieces), as provided
by soccer rules, to all events.
The league or tournament 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 travelling 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, or radio coverage of the league or tournament, without
I authorize that an unaltered copy of this form may be generated and given to the officers or directors of
other leagues or tournaments in order to allow my participation in their soccer programs, if the form is
required and I have requested to participate.
I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue, the
United States Soccer Federation, the State Association, the Club, the league and tournament, 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. This includes owners, lessors, and
lessees of premises, 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. My signature attests to this
on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin,
successors, and assigns.