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REGISTRATION

PLAYER REGISTRATION
APPLICATION

PARENT/GUARDIAN INFORMATION

PLAYER INFORMATION

NORTHAMPTON SOCCER CLUB WAIVER

We, the registrant and the registrant's legal parent or guardian, hereby agree and acknowledge the following: (1) We agree to abide by the rules of Northampton Soccer Club and its affiliated organizations and sponsors. (2) We recognize the inherent risk of serious or permanent physical injury and possible death associated with youth soccer activities and games. In consideration for Northampton Soccer Club accepting the youth player's registration and participation in its sanctioned youth soccer leagues, tournaments and team travel activi- ties (“Youth Programs”), we hereby release, discharge and/or otherwise indemnify and hold harmless Northampton Soccer Club, its affiliated organi- zations and sponsors, volunteers, their employees and associated personnel, including the owners of fields and facilities utilized for the Youth Programs, against any claim, lawsuit or written demand, including but not limited to any claims for personal or physical injury or death, by or on behalf of the registrant as a result of the registrant's participation in the Youth Programs and/or being trans- ported to or from the same, which transportation we hereby authorize. (3) We authorize verification of the registrant's date of birth from legal records to be provided to a Northampton Soccer Club authorized representative for the limited purpose of verifying the Northampton Soccer Club player's age and identity. (4) We consent to emergency medical care prescribed by a duly licensed Health Care Provider or Dentist. This care may be given under whatever conditions are necessary to preserve the life, limb or registrant's well-being and we hereby agree to be financially responsible for all costs associated with such treatment. (5) We consent to Northampton Soccer Club taking photographs, video re- cordings, and/or sound recordings in documenting the activities of Northampton Soccer Club's programs and services. We hereby grant Northampton Soccer Club and their affiliates' permission to use the negatives, prints, motion pictures, video/audio tapings, or any other reproduction of the same for Northampton Soccer Club and its affiliates' educational and promotional purposes in manuals, on flyers, the internet, or other publications. We have read this release and waiver of liability and fully understand its terms. We understand that we waive substantial rights by signing this form. We agree to waive all such rights above including the right to file a legal action or assert a claim for personal or physical injury or death of any kind. We sign this release form freely of our own free will.
I understand and AGREE by SUBMIT above that NO REFUNDS will be given after draft dates when players are assigned to teams
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