FC DELCO -- Boys ID Clinics (The Proving Grounds & USTC) - Player Registration/Waiver
FC DELCO is pleased to be holding boys open ID sessions. Please sign up to attend your current birth year. A parent must fill out and sign your player waiver.
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Email *
Which date(s) will you be attending? *
Required
Player First Name *
Player Last Name *
Player Birth Year: *
Position: *
Current Club:
Which clinic are you attending? *
Parent First Name (if player is a minor) *
Parent Last Name (if player is a minor) *
Phone (Or parent phone if player is a minor) *
Emergency Contact *
Emergency Contact Phone Number *
APPROVAL AND MEDICAL RELEASE Recognizing the possibility of physical injury, I, the above-named player OR parent/guardian of the above-named player, a minor, do hereby release, discharge and/or otherwise indemnify the FC Delco and its affiliated organizations including, without limitation, Continental FC and Spirit United SC, and their respective officers, coaches, referees, managers, board members, tournament hosts and their officials, employees and associated personnel, including the owners of the fields and facilities utilized for the Programs ("Programs," as used herein, means games, tournaments, clinics, practices, and/or soccer activities or social events organized by FC Delco or its affiliated organizations), against any and all claims by or on behalf of the above-named player as a result of such player's participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize by the officer, coach or agent(s) of the FC Delco. The above-named player has received a physical examination by a physician and has been found physically capable of participating in the Programs. I, the above-named player OR the parent/legal guardian of the above-named player, hereby give my consent to have an athletic trainer, doctor of medicine or dentistry, or other medical professional provide the above-named player with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of such assistance and/or treatment. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of the above-named player. *
Required
I (we), the undersigned parent(s)/guardian(s) of (please type child's full name) *
do hereby agree to release from any and all forms of liability whatsoever all persons associated with Tee’s Golf Center, LLC, Plymouth Industrial Center, Inc., and The Proving Grounds. I/We, hereby give my/our approval to participate in any and all league related activities. I/We know that participation in facility activities may result in serious injuries and protective equipment does not prevent all injuries. I/We acknowledge that I/We are aware of the COVID-19 virus and are aware of the risk and consequences of participating in facility activities which does not always provide for and afford the social distancing guidelines as mandated by the Centers for Disease Control, also referred to as the CDC, and other government agencies. I/We assume all risks and hazards including those associated with COVID-19 incidental to such participation including transportation to and from activities, and I/We hereby waive, release, absolve, indemnify and agree to hold harmless Tee’s Golf Center, LLC, Plymouth Industrial Center, Inc., and The Proving Grounds, the organizers, supervisors, participants and personnel transporting my/our child to and from activities, from any claim arising out of an injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance.Also, I/We, the undersigned parent(s)/guardian(s), do hereby agree to indemnify and hold harmless any and all of the above mentioned individuals and/or groups and/or organizations from any and all losses suffered by virtue of any and all suit started or judgement obtained on behalf of my/our child arising out of any and all sickness/injury including infections and illness resulting from exposure to the COVID-19 virus sustained in regard to participation in the facility.Also, I/We, the undersigned parent(s)/guardian(s), do hereby agree to that Tee’s Golf Center, LLC, Plymouth Industrial Center, Inc., and The Proving Grounds or its coaches and assistants shall have the right in the event of any and all emergency, injury or illness, to send the child to the nearest hospital or physician available for treatment.Also, I/We, the undersigned parent(s)/guardian(s), do hereby acknowledge that I/We have, or will, purchase the medical/hospitalization insurance to cover my/our child in the event in which medical attention is necessary because of any accident/illness that is the result of/or related to the activities of the facility. Also, I/We, the undersigned parent(s)/guardian(s), do hereby agree to release the above-mentioned individuals and/or groups and/or organizations from any and all liability and/or injuries and/or illness including, but not limited to, infection resulting from exposure to the COVID-19 virus, and/or damages sustained from the sharing of personally owned equipment. This release and indemnity agreement is executed with full knowledge and understanding; and with the intention that I/We shall be legally bound therein. Please answer "YES." *
Please Print Your Full Name as Your Signature: *
A copy of your responses will be emailed to the address you provided.
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