2021 SSF Event Sign-up
SSF Center is located at 14550 Westminster Way N, Shoreline, WA 98133
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Email *
First Name: *
Last Name: *
School: *
Grade? (e.g. 10th):
Parent's full name: *
Parent Email Address: *
Parent Phone Number: *
Physical Address: *
JRSL Dodgeball Night: Friday June 4th from 7pm-8:30pm @ Shoreline Sports Foundation- Westminster Center (14550 Westminster Way N, Shoreline, WA 98133) *
I have read the fact sheet for parents on concussion (https://www.cdc.gov/headsup/pdfs/youthsports/parents_eng.pdf) with my child or teen and talked about what to do if they have a concussion or other serious brain injury. *
I give permission for my child (if a minor) to participate in Shoreline Sports Foundation(SSF) activities. I, or my parent/guardian if I'm a minor, acknowledge and understand there are inherent risks in athletic activities and that injuries can result from participation in sports. I will assume the risk associated there with, whether known or unknown to me at this time.I release all SSF coaches, board members, volunteers, independent contractors, facility managers and the Shoreline School District from responsibility for accidental physical injury, including death, and for any expenses or liability incurred because of accident or injuries to me or my child (if a minor) from this activity. I understand that my personal insurance will be the primary coverage for me or my child’s accidents and that SSF’s insurance is secondary. *
"Return to Play" Waiver: In consideration of being allowed to participate in any way in the Shoreline Sports Foundation (“SSF”) programs, teams, trainings, related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. The risk of injury and/or illness from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist; 2. The risk to have contact with individuals, who have been exposed to and/or have been diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies does exist, and it is impossible to eliminate the risk that I could be exposed to and/or become infected through contact with or close proximity with an individual with a communicable disease; 3.I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume all full responsibility for my participation; 4. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and 5. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS SHORELINE SPORTS FOUNDATION, their officers, officials, agents and/or employees, coaches, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of the premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 6. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY AGREEING TO IT ON MY OWN BEHALF OR ON BEHALF OF THE YOUTH PARTICIPANT NAMED BELOW, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *
ACKNOWLEDGMENT BY PARENTS AND/OR LEGAL GUARDIANS OF YOUTH PARTICIPANTS: I agree to and verify the following: 1) I am the parent or legal guardian for the youth participant named above, 2) that as parent/legal guardian with legal responsibility for this youth participant, I consent and agree to assume the risks of his/her participation in these programs; and 3) that I specifically agree to his/her release as provided herein of all the Releasees, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to this youth participant's involvement or participation in these programs as provided above EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. My acceptance is noted with my electronic signature below. * *
By registering for SSF activities I give my consent for SSF to use photographs of my child for any lawful purpose unless otherwise agreed upon with SSF Staff. *
I agree to receive SSF emails containing updates, and I acknowledge I have the opportunity to unsubscribe at any time. *
A copy of your responses will be emailed to the address you provided.
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