Emergency Medical Release & Liability Waiver
Player Registration Form
Parent/ Guardian Information
Young Talent Soccer Academy-MN Waiver
We, the registrant and the registrant’s legal parent or guardian, hereby agree and acknowledge the following: (1) We agree to
abide by the rules of YTSA-MN and its affiliated organizations and sponsors. (2) We recognize the inherent risk of serious or permanent
physical injury and possible death associated with youth soccer activities and games. In consideration for YTSA-MN accepting the
youth player’s registration and participation in its sanctioned youth soccer leagues, tournaments and team travel activities (“Youth
Programs”), we hereby release, discharge and/or otherwise indemnify and hold harmless YTSA-MN, its affiliated organizations and
sponsors, volunteers, their employees and associated personnel, including the owners of fields and facilities utilized for the Youth
Programs, against any claim, lawsuit or written demand, including but not limited to any claims for personal or physical injury or
death, by or on behalf of the registrant as a result of the registrant’s participation in the Youth Programs and/or being transported
to or from the same, which transportation we hereby authorize. (3) We authorize verification of the registrant’s date of birth from
legal records to be provided to a YTSA-MN authorized representative for the limited purpose of verifying the YTSA-MN player’s age and
identity. (4) We consent to emergency medical care prescribed by a duly licensed Health Care Provider or Dentist. This care may
be given under whatever conditions are necessary to preserve the life, limb or registrant’s well-being and we hereby agree to be
financially responsible for all costs associated with such treatment. (5) We consent to YTSA-MN taking photographs, video recordings,
and/or sound recordings in documenting the activities of YTSA-MN’s programs and services. We hereby grant YTSA-MN and their
affiliates’ permission to use the negatives, prints, motion pictures, video/audio tapings, or any other reproduction of the same for
C and its affiliates’ educational and promotional purposes in manuals, on flyers, the internet, or other publications. We have read
this release and waiver of liability and fully understand its terms. We understand that we waive substantial rights by signing this
form. We agree to waive all such rights above including the right to file a legal action or assert a claim for personal or physical
injury or death of any kind. We sign this release form freely of our own free will.
Ride-share authorize
As parent/guardian of the named player,
I acknowledge the following the rules of
the club and I will bring my child on time
and I will pick up right of the
game/practice. Coaches will not allow
your child to ride unknown person/friend
until we have authorized latter.
Emergency Medical Release & Liability Waiver
THIS AUTHORIZATION FOR EMERGENCY MEDICALTREATMENT MUST BE COMPLETED BEFORE PARTICIPANT
(PLAYER/COACH/REFEREE) CAN PARTICIPATE IN ACTIVITIES. TREATMENT FOR INJURY WILL BE BASED ON
INFORMATION PROVIDED HEREIN.
l, the undersigned participant and parent/guardian of the above listed minor (if participant is under the age of 18) acknowledge and fully understand that
each participant will be engaging in activities that involve risk of serious injury, including permanent disability or death, and severe social and economic
losses which might result not only from their own actions, inactions or negligence, but action, inaction or negligence of others, the rules of play, or the
condition of the premises or of any equipment used and further, that there may be other unknown risks not reasonably foreseeable at this time, assume
all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, hereby release, discharge,
covenants to indemnify and not to sue Young Talent Soccer Academy-MN, its directors, officers, employees, coaches, managers, agents, sponsors and
associated personnel including those of its affiliated organizations, and the owners and lessors of premises used to conduct the event, all of which are
hereinafter referred to as ‘releases’, from any and all liability to each of the undersigned, his/her heirs or next of kin for any and all against any claim by or
on behalf Of the applicant as a result Of the applicant’s participation in the Programs and/or being transported to or from the same, which participation,
after careful consideration I hereby authorize, and which transportation I hereby authorize. The applicant/participant has received a physical examination
by a physician and has been found physically capable of participating in the Programs. I hereby give my consent to have an athletic trainer, coach and/or
doctor of medicine or dentistry or associated personnel to provide the applicant/participant with medical assistance and/or treatment and agree to be
financially responsible for the cost of such assistance and/or treatment. l, also agree to save and hold harmless and indemnify each and all parties herein
referred to above as releases from all liability, loss, cost, claim or damage whatsoever, including death or damage to property, which may be imposed
upon said releases because of any defect in or lack of such capacity to so act or caused or alleged to be caused in whole or in part by the negligence of the
releases. I have read the above waiver/release and understand that (l) we have given up substantial rights by signing this release and sign below
voluntarily. I understand that this document may not be altered in any manner and that any alternation without the express written consent from the
Young Talent Soccer Academy-MN will cause the participant to be removed from the Program.