Colonial Soccer Club Men's Soccer Program

Please complete this form to ensure that your enlistment in the Colonial Soccer Men's Program and placeed on an email list which will inform you about practices, training, tryouts, games, and organized leagues.
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AUTHORIZATION TO PLAY, MEDICAL RELEASE, AND WAIVER

With the answering the check box below, permission is hereby granted to participate in all practice sessions, games and other activities involving the Colonial Soccer Club. This permission extends to any travel to and from any and all practice sessions, games, tournaments and other activities sponsored and arranged by Colonial Soccer Club, US Club Soccer, EPYSA, EPSA, US Youth Soccer, or the USSF, or any affiliate of any of these named groups. This permission is granted without reservation. Recognizing the risks presented by the competitive contact sport of soccer, the check box(s)below indicates a knowing, voluntary release of any claim which might be asserted against the any of the above named entities, their officers, administrative assistants, coaches, assistant coaches, managers, sponsors, chaperones, designated drivers, volunteers, and other agents representing those entities and its officers or agents or representatives. By waiving any rights to assert a claim, I am agreeing to release absolve, indemnify and hold harmless any and all parties previously mentioned for any and all liability arising from any injuries incurred by participant in the Club, its games, practices, tournaments, etc... My waiver expressly means that I accept and assume all risks and hazards inherent in and related to the activities of the participants engagement in soccer activity as herein noted, including any travel to and from or participation in any activities sponsored and arranged by any of the above listed entities.



EMERGENCY MEDICAL TREATMENT AUTHORIZATION

I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge, and otherwise indemnify the club, Colonial Soccer Club, US Club Soccer, EPYSA, EPSA, US Youth Soccer, their sponsors, the USSF and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the soccer player named above as a result of that player’s participation in Plymouth Soccer programs and/or being transported to or from the same, which transportation I hereby authorize.



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