Starfinder Foundation Spring Middle School League - Youth Athletic Waiver and Release of Liability 2020
PLEASE TYPE YOUR FIRST AND LAST INITIAL TO ACCEPT EACH CONDITION
Permission Waiver
PLEASE TYPE YOUR FIRST AND LAST INITIAL TO ACCEPT EACH CONDITION
As the parent or legal guardian of the minor child listed on this form, I give permission for him/her to participate in a Starfinder League. I understand that this permission slip includes my permission for my child to participate in soccer at Starfinder which will be supervised by Starfinder staff. *
Your answer
I understand that Starfinder assumes no responsibility for seeing to it that the minor reports to activities at the Starfinder sponsored program, and I, on my own behalf and on behalf of this minor, waive all claims for any liability arising or actions occurring before the minor has reported to the Starfinder program. *
Your answer
Liability Release
I, the parent/guardian of the minor, agree that I and the minor will abide by rules set forth by Starfinder. *
Your answer
My child has received a physical examination and has been found physically capable of participating in soccer. *
Your answer
Recognizing the possibility of physical injury associated with soccer and physical activity and in consideration for Starfinder accepting minor for its program, I assume all risks and hazards incidental to athletic participation and hereby release, discharge and/or otherwise indemnify Starfinder, its officers, directors, coaches, sponsors, volunteers, agents and affiliates, against any claim by or on behalf of the minor as a result of the minor's participation in soccer. *
Your answer
Permission to Use
I grant permission to use photographs/videography of my minor child in print or online materials designed for news, informational or educational purposes related to the Starfinder Foundation. *
Your answer
I grant permission to allow Starfinder to collect basic demographic information about my minor child (age, race, ethnicity, home zip code, etc) to be used to better understand the students who become part of our community and to demonstrate our value to existing and potential funders. All data collected will remain anonymous. *
Your answer
Youth's first name *
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Youth's last name *
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Youth's Date of Birth *
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Youth's Gender *
Youth's Ethnicity (Please check all that apply) *
Required
Youth's Grade *
Coach's Name *
Your answer
Team Name (if known)
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Guardian's First and Last Name *
Your answer
Guardian's email address *
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Guardian's phone number *
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Guardian's home address (street) *
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Guardian's City *
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Guardian's State *
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Guardian's Zip *
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My initials below indicate that I have read, understood, and freely consented to this agreement. Further, I certify that I am over 18 years of age and that I am otherwise legally competent to consent to this agreement. *
Your answer
Effective date: (today - date is automatically entered)
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