Greer Athletics Registration form and waiver

Athletics Registration Form and Waiver

Sport Currently Registering: FSCG Academy Soccer
PLAYER INFORMATION:
Child Name*

First NameLast Name
Date

MonthDayYear
Date
Player Email
example@example.com
Birth Date*

MonthDayYear
Player Age
School
Grade
Male/Female*
Volunteer Coach*
City of Greer Resident?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Click Below to upload a copy of your child's birth certificate

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UNIFORM INFORMATION

For equipment purposes, please list height and weight
Jersey Size
Height
Weight
City of Greer Resident's taxes financially support our program and facilities, In turn; city of Greer resident’s receive discounts on registration fees. Information found to be incorrect after verification of address may result in the collection of additional fees.
PARENT/GUARDIAN INFORMATION:
Primary Parent/Guardian*

First NameLast Name
Primary E-mail*
Text/Phone*

Area CodePhone Number
Second Parent/Guardian*

First NameLast Name
Second E-mail*
example@example.com
Text/Phone*

Area CodePhone Number
EMERGENCY CONTACT:

(Other than parents)
Contact 1*

First NameLast Name
Text/Phone*

Area CodePhone Number
Contact 2*

First NameLast Name
Phone Number*

Area CodePhone Number
MEDICAL INFORMATION
My child is subject to the following allergies or medical conditions and I authorize Greer Parks and Recreation to disclose such allergies or medical conditional to a physician in the event my child should require medical care.
Medical Concerns
Physician Name

First NameLast Name
Phone Number

Area CodePhone Number

RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT FOR MINOR PARTICIPANT
My Child's Name*

First NameLast Name
In consideration of my child being allowed to complete in Greer Parks and Recreation athletic programming, I acknowledge, appreciate, and agree that: The risk of injure to my child from the activities involved in these programs are significant, including the potential for permanent disability and death.

Release and Indemnity

I for myself my spouse, child and my spectators and guests my/our heirs, assigns, personal representatives and next of kin (hereinafter participants), knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my child’s participation; and, I myself, and my participants, herby release indemnify, hold harmless, and forever discharge Greer Parks and Recreation, City of Greer employees, volunteers, officials, coaches, successors, assigns, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises uses to conduct the event (releases),of any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages, and liabilities, of every kind and nature, whether known or unknown, in law or equity, that my, my children, or my guests ever had or may have, arising from or in any way related to my child’s participation in or transportation to and from any activities conducted by, on the premises of, or for the benefit of, Greer Parks and Recreation, with respect to any and all injury, disability, death, or loss or damage to person or property incident to my child’s involvement or participation in these programs, where arising from the negligence of the releases or otherwise, to the fullest extent permitted by law. I further agree that I will be responsible for the releases attorney fees and costs that are related to any such claim brought by me or my participants.

I, parent or guardian of the aforementioned participant, hereby give approval to his/her participation in any and all athletic activities. I assume all risks and hazards incidental to such participation including transportation to and from activities, and do herby waive, release, absolve, indemnify, and agree to hold harmless the parent or local league organization, the organizers, sponsors, supervisors, volunteers, participants, and persons transporting the youth to and from activities for any claims arising out of any injury to the youth, except to the extent and in the amount covered by the accident and/or liability insurance held by association.

I also grant permission to permit athletic staff and employees to the recreation department or other person to authorize and obtain medical care from any licensed physician, hospital, or medical clinic should the youth become ill or injured while participation in the athletic activities away from home, or at other times when neither parent in available to grant authorization for emergency treatment.

I also grant permission for my child’s photograph to be used to Greer Parks and Recreation in future advertisements and publications to promote athletic programming.

Emergency Medical Decisions

I agree to remain in reachable proximity to my child during all Greer Parks and Recreation activities. However, in the event I cannot be reachable. I authorize Greer Parks and Recreation staff to make emergency medical decisions for my child. I understand that I am responsible for all medical treatment costs.

I have read this release of liability and assumption of risk agreement, fully understand its terms and understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without inducement.

I understand the seriousness of the risks involved in participating in this program, my person responsibilities, for adhering to the rules and regulations, and accept them as a participant.
Parent Name*

First NameLast Name
Parent Signature*

Clear
Parent Name

First NameLast Name
Parent Signature

Clear
Should be Empty:

Athletics Registration Form and Waiver

PLAYER INFORMATION:

UNIFORM INFORMATION

PARENT/GUARDIAN INFORMATION:

EMERGENCY CONTACT:

MEDICAL INFORMATION

RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT FOR MINOR PARTICIPANT