Roseville Soccer Trial Registration
Thank you for your interest in joining one of the Roseville SC's competitive teams. Prior to joining any field activities, you must complete the following information below. 

**Please note that should you currently be affiliated with another club, we will need the written approval from the club's DOC that you are allowed to join our training for evaluation purposes.**

 Please email the written approval or have DOC email us directly at: doc@rosevillesoccer.com  

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Email *
Alternative Email Address
Contact Phone Number *
Player First Name *
Player Last Name *
Player Gender *
Age Group (Year your player was born) *
Primary Position
Level of Play
Where did you play last year?
If "Other", please tell us where you played last year.  Any other information welcome.
MEDICAL TREATMENT AUTH. & LIABILITY WAIVER
I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment should it become necessary during, before or after the tryout activity. I agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge, and otherwise indemnify Roseville Youth Soccer Club and Roseville Premier, US Club Soccer, Cal North, their sponsors, the USSF and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the soccer player named above.
Medical Treatment Auth. and Liability Waiver *
Required
VISUAL/AUDIO IMAGE RELEASE FORM
I hereby consent to the possible publication either directly, indirectly or inadvertently, the use of my child’s Likeness (“Likeness”) for promotion, publicity, marketing, and advertising, or other manner or media by RYSC or any other representative authorized to act on behalf of the afore-mentioned entity.  Likeness shall include, but not be limited to, photographs, sound or audio recordings, films, broadcasts, podcasts, brochures, publications, reports, web pages, promotional materials or any other audio-visual, electronic, printed, tangible work in any media or format, now known or hereafter to become known, or reproductions of any of these.  I agree that the actual material involved is and shall continue to be the property of RYSC and that neither I nor my child, shall have any right of review or approval regarding the use of my child’s name ore Likeness in such material
I hereby release and hold harmless RYSC along with their respective board, directors, employees, contractors, coaches, volunteers, agents, affiliates, sponsors, or other representatives from any claims, demands, or causes of action arising out of the use of my child’s name or Likeness, under the terms of this release.  I understand and agree that my child nor I will be compensated in any way for the use of my child’s name or Likeness by RYSC.   
VISUAL/AUDIO IMAGE RELEASE FORM *
Required
COVID LIABILITY WAIVER
Roseville Youth Soccer Club, a California Corporation (“the Club”) is taking precautions to reduce the spread of the novel coronavirus (“COVID-19”); however, the Club cannot guarantee that its players (and their family members), coaches, referees, and/or spectators will not become infected with COVID-19.  By signing below, each player named above (“Player”), by and through the Player’s parent or legal guardian (“the Undersigned”) understands and agrees and voluntarily assumes the risk that, by playing soccer and/or engaging in soccer-related activities, the Player may be exposed to or infected with COVID-19 and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death to the Player or a member of the Player’s family.  The Undersigned acknowledges the risk of the Player becoming exposed to or infected with COVID-19 and further acknowledges that an exposure or infection may result from the actions, omissions, or negligence of the Player and others, including, but not limited to, the Club and its employees, agents, board of directors, officers, and volunteers. The Undersigned hereby releases, discharges, and otherwise agrees to indemnify the Club, US Club Soccer, their sponsors, the USSF and its affiliated organizations, and the employees, board members, officers, and associated personnel of these organizations, against any claim by or on behalf of the Player as a result of the Player’s participation in US Club Soccer or Club programs, including as a result of any COVID-19 related exposure or infection.By voluntarily singing this Agreement, the Undersigned expressly agrees, for his or herself, for the Player, and for any family members, to release and hold harmless the Club, its employees, agents, board of directors, officers, volunteers, and representatives, of and from any and all claims, including all liabilities, causes of actions, defenses, damages, equitable rights, attorneys’ fees, and costs or expenses, of any kind arising out of or relating to playing soccer and/or engaging in soccer-related activities, including as to any COVID-19 related infection or exposure.  The Undersigned understands and agrees that this release includes any claims related to COVID-19 based on the actions, omissions, or negligence of the Club, its employees, agents, board of directors, officers, volunteers, and representatives, whether COVID-19 exposure or infection occurs before, during, or after playing soccer or engaging in soccer-related activities.  The Undersigned further expressly agrees that this Agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.  THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
Covid Liability Waiver *
Required
Please type full name in lieu of signing below *
A copy of your responses will be emailed to the address you provided.
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