Toca Juniors Football Club | Spring Soccer Program

Child Information

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Gender

Insurance Company

Policy Number

Relation to player (choose one):

FatherMotherGuardian

Parent's/guardian's

First NameMiddle NameLast Name

Address

Street Address

Street Address Line 2

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Postal / Zip CodeCountry

Payment:

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Please indicate how you heard about Fall training program:

Primary E-mail

Alternate E-mail

example@example.com

Mobile Number

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Phone Number

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Additional Comments

• In consideration of being allowed to participate in any way in Toca Juniors Football Club programs, related events, and activities, I the undersigned, on behalf of myself and my participating, acknowledge, appreciate, and agree that:

I am aware there are risks to me of exposure to directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof.

Participation in Toca Juniors Football Club programs, events, and activities involves the potential exposure to, and illness from infectious, communicable diseases, including COVID-19. While following Federal and State guidelines and Toca Juniors Football Club Safety Guidelines may reduce the risk, THE RISK OF SERIOUS ILLNESS AND DEATH DOES EXIST. TOCA JUNIORS FOOTBALL CLUB CANNOT, AND DOES NOT GUARANTEE, WARRANT, OR REPRESENT THAT PARTICIPANTS WILL NOT CONTRACT A COMMUNICABLE DISEASE, INCLUDING BUT NOT LIMITED TO COVID-19, AS A RESULT OF PARTICIPATION IN ITS PROGRAMS, EVENTS, OR ACTIVITIES.

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, HOLD HARMLESS, AND FOREVER DISCHARGE Toca Juniors Football Club, its officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, liability, rights, or causes of action of whatsoever kind arising out of, or in any way connected to or related to any ILLNESS, INJURY, DISABILITY, DAMAGES OR DEATH I may suffer or sustain as a result of my participation in Toca Juniors Football Club programs, events or activities, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, ACKNOWLEDGE THAT IT CONSTITUTES A BINDING AGREEMENT AND PROMISE, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I understand that my completing and submitting this Release of Liability and Assumption of Risk Agreement constitutes a legal signature confirming that I acknowledge and agree to the terms and conditions included herein.

Photography/Video Consent And Release Form
• I hereby grant permission to Toca Juniors Football Club representatives, to take and use videos, photographs and/or digital images of my child for use in:
1. Media releases, media articles - including newspapers, radio, television - printed publications and/or educational materials.
2. Electronic publications and communications such as the club's Social Media and website.
3. I agree that my child's name and identity may be revealed in descriptive text or commentary in connection with the image(s).
4. I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions and shall be the property of Toca Juniors Football Club.

Participant’s Print Name:

First NameLast Name

FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

I understand that my completing and submitting this Release of Liability and Assumption of Risk Agreement constitutes a legal signature confirming that I acknowledge and agree to the terms and conditions included herein.

Signature Date