2017 UEFC Academy Finishing and GK Clinic
Registration Form for the UEFC Finshing and GK Clinic
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Assumption of Risk, Release of Liability, and Consent to Medical Treatment As a condition of my child’s participation in the Aces Soccer Camp, and in consideration for the privileges that come from participation in that camp, which may include instruction, use of facilities and equipment, and other services provided by the Aces Soccer Camps, I hereby agree for my minor child as follows: 1. I recognize and understand that the Aces Soccer Camp is a coach’s camp offered and operated by Aces Soccer Camp. The camp is not a University of Evansville sponsored activity and the University of Evansville does not have any responsibility for the operation of the camp. 2. I recognize that the Aces Soccer Camp will involve various activities that may include, but are not limited to, instruction, conditioning, practices, games, meals, lodging and travel to and from Aces Soccer Camp. 3. I recognize that there are certain risks of harm to my child and others associated with my child’s participation in the Aces Soccer Camp and camp activities, that there are dangers that cannot be foreseen, that there are risks and dangers that the Aces Soccer Camp and its agents and employees cannot control, and that such risks and dangers could result in bodily injury or death to my child and/or to others. 4. I understand that some of the dangers and inherent risks to my child in playing or practicing any sport include, but are not limited to, death, serious neck and spinal injuries that may result in complete or partial paralysis, brain damage, serious injury related to the eye and/or head, serious injury to virtually all internal organs, serious injury to all bones, joints, ligaments, muscles, tendons, and other parts of the muscular/skeletal system, and serious injury or impairment to other aspects of my child’s body and general health and well-being. I further understand that there are risks associated with travel and that my child could incur some or all of these injuries during travel to and from the Aces Soccer Camp. 5. I acknowledge that the Aces Soccer Camp has strongly recommended to me that my child seek medical advice concerning his/her physical health, conditioning and abilities prior to engaging in any camp activities. I further acknowledge that my child does not have any medical conditions that would affect his/her fitness to participate in camp activities. 6. I agree that if any injury or emergency should occur during camp with respect to my child, the Aces Soccer Camp staff is authorized to take whatever steps are reasonably necessary in their judgment to attend to my child’s medical needs. I agree to be responsible for any hospital expenses, doctor’s bills, or other expenses that may be incurred to attend to my child’s medical needs. 7. I represent that my child has adequate health insurance to cover the cost of treatment in the event of any injury he/she incurs during participation in the Aces Soccer Camp. 8. I agree to assume all risks and responsibility for any and all claims for damages including personal injury or death, medical expenses, disability, lost wages, loss of earning capacity and property damages that may be incurred by my child while engaged in camp activities. 9.I, on behalf of my child, my personal representatives, heirs, executors and assigns, agree to hold harmless Marshall Ray, Aces Soccer Camp, and the University of Evansville and their agents and employees from any and all liability, including claims, demands, causes of action (known or unknown), suits or judgments of any and every kind (including attorney’s fees), arising from any injury, property dam-age, or death that my child may suffer as a result of participation in the Aces Soccer Camp, regardless of whether the injury, damage, or death is caused by the Aces Soccer Camp or otherwise, unless the injury, damage, or death is caused by the Aces Soccer Camp’s negligence, gross negligence, or intentional misconduct. 10. I further agree that in the event that I or any of my family members, personal representatives, heirs, executors and assigns, or any other third party attempts to assert any claims, demands, causes of action (known or unknown), suits, or judgments of any and every kind (including attorney’s fees), arising from any injury, property damage, or death to my child, including but not limited to any injury resulting from my child’s own negligence, gross negligence, or intentional misconduct during or related to the Aces Soccer Camp activity, I agree to defend and indemnify Marshall Ray, Aces Soccer Camp, and the University of Evansville against such claims, demands, causes of action, (known or unknown), suits, and/or judgments of any and every kind (including attorney’s fees) to the fullest extent permitted by law. In signing this release, I acknowledge and represent that I have carefully read the foregoing, that I understand it, and that I sign it voluntarily as my own free act and deed. No one has made any oral representation, statement, or inducements in order to get me to sign this document. I have had the opportunity to consult with my own legal counsel before signing this document. I am signing this agreement on behalf of a Minor Participant. I acknowledge that I am the guardian or parent of the participant who is less than 18 years of age and that I understand the terms of this agreement. This agreement shall be binding upon the participant and the participant’s parents, guardians, heirs, and personal representatives. *
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