PARENT (OR PLAYER IF 18 OR OLDER), PLEASE USE YOUR FINGER TO SIGN YOUR NAME IN THE BOX BELOW AFTER READING THE FOLLOWING:
I understand there are no refunds.
MEDICAL TREATMENT AUTHORIZATION
I hereby give my consent to Capital Community Athletics, Inc. (CCA) 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.
WAIVER & RELEASE OF LIABILITY
I recognize the possibility of physical injury associated with soccer and/or the activity listed above and hereby assume all of the risks of participating in that activity with CCA, including for example any risks that may arise from negligence or carelessness on the part of the persons being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity with CCA. I acknowledge that this Waiver and Release of Liability form will be used by the organizers and that it will govern my actions and responsibilities with CCA.

In consideration for being allowed to participate, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
I WAIVE, RELEASE, AND DISCHARGE CCA, its sponsors, hosting organizations, employees, volunteers and associated
personnel of these organizations from any and all liability, including but not limited to liability arising from the negligence or fault of those persons and entities, for my death, disability, personal injury, property damage, property theft, and injury or damages of any kind which may befall the player/participant named above as a result of that player’s participation in any sport or training program and/or being transported to or from the same, which transportation I hereby authorize.
I INDEMNIFY AND HOLD HARMLESS CCA, its sponsors, hosting organizations, employees, volunteers and associated
personnel of these organizations, from any and all liabilities or claims made as a result of participation in this activity with CCA,whether caused by negligence or otherwise, and hereby AND PROMISE NOT TO SUE any of them for such liabilities or claims.
I acknowledge that this activity may carry with it the potential for death, dismemberment, serious injury, and personal loss.
The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants,
equipment, vehicular traffic, actions of other people (such as participants, volunteers, spectators, and coaches), and lack of
hydration.
Photographic Release: I grant and convey to CCA all right, title and interests in any and all photographs, images, video, or audiorecordings of me and/or participant or our likeness or voice made by CCA in connection with all of my interactions with CCA.
The above waiver, release of liability, and photographic release shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL.
Parent/Guardian Waiver for Minors
The undersigned parent or natural guardian hereby represents that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the above activity with CCA, and has agreed, individually and on behalf of the child or ward, to the terms of the Waiver & Release of Liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify CCA, its sponsors, hosting organizations, employees, volunteers and associated personnel of these organizations, from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon them because of any defect or lack of capacity to so act and release said parties on behalf of the minor and the parents or legal guardians.