Palm Beach Rush - 2024/25 Tryouts Registration Form
Thank you for your interest in joining Palm Beach Rush. 

Tryouts for the 2024/25 season will take place at the Mandel Recreation Center in Palm Beach (340 Seaview Ave, Palm Beach, 33480) with the following schedule: 

Monday, May 6th 4:00 PM - 5:30 PM - 2012-2016 GIRLS
Tuesday, May 7th 4:00 PM - 5:30 PM - 2012-2016 BOYS
Wednesday, May 8th 4:00 PM - 5:30 PM - 2012-2016 GIRLS
Thursday, May 9th 4:00 PM - 5:30 PM - 2012-2016 BOYS

Tryouts are mandatory for both current and new players. Please fill the following form to register. Thank you very much. 
Sign in to Google to save your progress. Learn more
First Name (Parent) *
Last Name (Parent) *
First Name (Player) *
Last Name (Player) *
Age Group Interested In Joining *
Are you a current Palm Beach Rush player? If coming from another club, please specify the name of the club below.  *
Birth Date *
Gender *
Email Address *
Home Address *
Phone Number *
Additional Comments / Observations
Waiver/Release for Injury, Loss & Communicable Diseases including COVID-19:

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT
In consideration of being allowed to participate on behalf of Select Soccer Academy LLC (dba Palm Beach Rush) athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does 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 as regards protection against infectious diseases. If, however, I observe and any unusual or 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, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLDHARMLESS Select Soccer Academy LLC, their officers, officials, coaches, members, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“releasees”), while participating in activities of any kind whether sponsored by or under the supervision of Select Soccer Academy LLC and with respect to any and all illness, disability, death, or loss or damage to person or property, whether arising from the negligence of releasees or otherwise, to the fullest extent permitted by law.

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
I have read this release of liability and assumption of risk agreement, I fully understand its terms, and sign it freely and voluntarily without inducement for participants of minority of age (under age 18 at the moment of registration) *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Rush Soccer. Report Abuse