Parental Permission And Waiver For Emergency
Treatment
I, the undersigned, as the parent or legal
guardian of the child named below, do hereby give my full consent
and approval for my child to participate as a member of Clearwater First
Nazarene Church Soccer Program (CFNSP).
I understand that there are certain risks of damages and injuries, including
death, inherent in the practice and playing of sports, as well as in
traveling in other related activities incidental to my child's participation,
and I am willing to assume these risks on behalf of my child. These risks
include, but are not limited to, those hazards associated with weather
conditions, travel, playing conditions, equipment and other participants.
I understand that the very nature of Sports is hazardous and risky, including,
but not limited to, the acts of running, jumping, stretching, sliding,
diving and collisions with other players, volunteers and stationary objects,
all of which can cause serious injury or death to my child and to other participants.
Further, I agree that in consideration for the right to allow my child to
participate as a member of the team designated below and in consideration
for permission to play in the gymnasium or on other fields as arranged for by
the team or CFNSP:
1. On behalf of my child and myself, I do voluntarily elect to accept and
solely assume all risks of injury incurred or suffered by my child (a)
while practicing or playing as a member of the team so designated,
(b) while serving in a non-playing capacity as a team member or observer
during practice or play by other teams or by other players on my child's
team, and (c) while on or upon the premises of any and all of the fields arranged
for by the team or the CFNSP for practice or play.
2. In addition to giving my full consent for my child's participation, I do
hereby waive, release, discharge and agree not to sue the team designated
below, Clearwater First Nazarene Church, the owner or operator of any field, or any person or
entity connected with the team, the CFNSP or field for any claim, damages, costs
including attorneys fees, or cause of action which I or my child have or
may have in the future as a result of damages, injuries, including death,
sustained or incurred by my child from whatever cause including, but not limited
to, the negligence, breach of contract or wrongful conduct of the parties
hereby released.
I hereby certify that my child is fully capable of participating in sports and
that my child is healthy and has no physical or mental disabilities or
infirmities that would restrict full participation in these activities, except
as made known to coaches and officials of the team and the CFNSP.
I further agree on behalf of myself and my child listed below, that I shall
hold harmless and fully indemnify the parties hereby released from any and
all claims, damages, costs including attorney fees, and causes of action
which may arise from any cause of action made by me or by, through or on
behalf of my child, even if the damages, injuries or death are caused in whole or in part by any of the persons or entities
hereby released.
I acknowledge (a) that I have read (or have had read to me) each and every one
of the provisions in this waiver, release of liability and indemnification
agreement, (b) that I understand each of the provisions in this agreement
and ( c) that I agree to abide by them.
Please type name.