3v3 Wavier and Emergency Contact Info

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Player First and Last Name *

Parent(s) Name *

Email *

Secondary Email

Primary Phone Number *

Secondary Phone number

Team Name *

I understand and agree to waiver of liability for Coerver Arizona.

I am the parent/legal guardian of the Player registered to participate in a Coerver Arizona program. I understand and agree that there is a risk of injury and potential danger of exposure to COVID-19 to Player while participating in Coerver Arizona programs and recognize every activity has a certain degree of risk, some more than others.

By allowing Player to participate in Coerver Arizona programs, I knowingly and voluntarily assume any and all risk of injuries and exposure to COVID-19, regardless of severity, which from time to time may occur as a result of Player’s participation in athletic and other activities through Coerver Arizona. I hereby certify that I have adequate health insurance to cover any injury, sickness or damages that Player may suffer while participating, or alternatively, agree to bear all costs associated with any such injury or damages my Player. I hereby give permission for the staff of Coerver Arizona to seek appropriate medical attention for the Player and for the medical attention to be given and for the Player to receive medical attention in the event of accident, injury or illness. I will be responsible for any and all costs of medical attention and treatment. I, the undersigned for Player, myself, our heirs, executors and administrators waive, release and forever discharge SportsMethod USA Inc, Coerver Arizona, Soccerball Mastery LLC and its staff, officers, agents, employees, representatives and successors and assign of and from all rights and claims for damages, injury or loss to person or property which may be sustained or occur during participating in Coerver Arizona activities or while at a Coerver Arizona program, whether or not damages, injury or loss is due to negligence. I agree to indemnify and hold Coerver Arizona members including but not limited to any adjoining facilities from any and all claims, suits, or proceedings arising allegedly or in reality out of the acts of omission and participation of the undersigned in any or related activity. I hereby acknowledge that Player is physically fit and mentally capable of participating in soccer activities.
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