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1 | Canton Akron Cup Youth Team Waiver | ||||||
2 | TEAM NAME ______________________________ Coach ____________________________________ | Age Bracket_______________________________ | |||||
3 | TEAM CONTACT ____________________________________________ | ||||||
4 | Players | Legal Guardian | |||||
5 | First Name | Last Name | First Name | Last Name | Date | PARENT’S SIGNATURE | |
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24 | Waiver Form | ||||||
25 | REPRESENTATIONS, ACKNOWLEDGEMENTS, AND AGREEMENTS: | ||||||
26 | 1. I hereby represent and certify that the age of the registrant listed is correct and acknowledge and agree that the registrant is physically fit | ||||||
27 | to engage in both structured and unstructured activities at the Canton Akron Cup. | ||||||
28 | 2. I acknowledge the inherent risk of serious injury or even death associated with soccer activities and I hereby release, discharge, and agree to | ||||||
29 | indemnify and hold harmless Bowling Green State University its Board of Trustees, Officers, Employees & Agents, Valentis Athletica LLC, | ||||||
30 | Net Results LLC, its owners, managers, affiliates, and employees and from any and all claims by or on behalf of the registrant | ||||||
31 | arising from the registrant’s participation in activities at the Canton Akron Cup. | ||||||
32 | 3. I have received and viewed the "Return to Play - What Parents-Guardians Need to Know " concussion information sheet. | ||||||
33 | 4. I herby represent and certify that the registrant has adequate health insurance to cover any and all injuries occurring as a result of participation | ||||||
34 | in soccer activities at the Canton Akron Cup and as participant, I hereby consent to any and all emergency medical care for participant and | ||||||
35 | agree to pay for same. | ||||||
36 | I certify that the above information is correct | ||||||
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38 | Coach or Team Contact ___________________________________________ | _____________________________________ | |||||
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