Guest Pass Registration Form

Registration Type

Status

Complete Pending

Today's Date *

Month Day Year

Event *

Guest Pass

Time

: Hour Minutes AM/PM Option

Registration Type *

10-Day Guest Pass $15.00

Dates of Pass *

Please enter the dates you would like the pass to be valid (max 10-days)

Player Information

Gender *

Male Female

Calculation

Full Name *

First Name Last Name

Birth Date *

Month Day Year

Age

Players under the age of 18, and a parent or legal guardian, will need to complete the Liability/Concussion Waiver. (See below.)

Player's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Player's E-mail

Home Phone Number

Area Code Phone Number

Work/Cell Phone

Area Code Phone Number

Citizenship

Items to Upload

Color photo of face *

Browse Files

Please upload a color photo of the player's face.

Front of Photo ID showing date of birth *

Upload a File

Please upload a copy of your photo ID showing date of birth.

Back of ID showing signature *

Upload a File

Please upload a copy of your photo ID showing date of birth.

Delivery/Pick-up Options

Delivery Options *

Mail to player Mail to different address Hold for pick-up (during office hours) Hold and tape it to the door (after-hours pick-up) Pick up and pay during office hours

Mail the card to the attention of

First Name Last Name

Mail the card to this address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Payment

Amount due at pick-up

Billing Information

Billing address is same as player's address

Amount to pay *

USD total

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Liability Waivers

Parent/Concussion Waiver

Download and review the materials and guidelines related to concussions by clicking here.

In accordance with Senate Bill 721 (“Jenna’s Law”), concussion training and procedural guidelines are now in effect for Oregon coaches, managers, referees, and players under the age of 18 and their parents or legal guardians. For each year of participation, and prior to a player under the age of 18 participating, at least one parent or legal guardian must acknowledge receipt and review of the guidelines and materials related to concussions as described in the law. If the player is age 12 or older, the player must also acknowledge receipt and review of guidelines and materials.

Acknowledgment of Concussion Guidelines and Materials

Parent/Guardian Acknowledgement

I have received and reviewed the guidelines and materials regarding the warning signs of a concussion. I agree that my child must be removed from practice/play if a concussion is suspected and that it is my responsibility to seek medical treatment if a suspected concussion is reported to me. I understand that my child cannot return to practice/play until providing written clearance from an appropriate health care provider to his/her coach or team manager and I understand the possible consequences of my child returning to practice/play too soon.

Player Acknowledgement

I have received and reviewed the guidelines and materials regarding the warning signs of a concussion. I understand the importance of reporting a suspected concussion to my coaches and my parents/guardian and that I must be removed from practice/play if a concussion is suspected. I understand that I must provide written clearance from an appropriate health care provider to my coach or team manager before returning to practice/play and I understand the possible consequences of returning to practice/play too soon and that my brain needs time to heal.

Parent’s Liability Release

In consideration of the participation of my child, who currently is not at least 18 years old, in soccer games and other programs conducted by or under the sanction of the Oregon Adult Soccer Association, Inc. (OASA) and its affiliated leagues, I hereby release and hold harmless OASA and all of its affiliated leagues, referees and sponsors, and all of their directors, officers, parent entities, affiliates, agents, employees, successors and assigns, from any and all claims, actions, losses, damages or expenses for personal or bodily injury (including death), and property loss or damage, incurred by me or my child or arising out of or in connection with my child’s participation in soccer games and other programs conducted by or under the sanction of the OASA and its affiliated leagues.

US Adult Soccer Parental Waiver

In consideration of being allowed to participate in any way for the United States Adult Soccer Association, Inc., Its Affiliates, Leagues, and Member Teams, its related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1) The risk of injury or illness from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or illness does exist; and,

2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS OF INJURY OR ILLNESS, both known and unknown to me at the time of this agreement, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will bring such to the attention of the nearest official immediately; and

4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the United States Adult Soccer Association, Inc. Its Affiliates, Leagues and Member Teams, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, 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, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

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 liabilities incident 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.

Parent or Legal Guardian's Name

First Name Last Name

Parent or Legal Guardian's Phone Number

Area Code Phone Number

Parent or Legal Guardian's Email

Parent/Guardian ID (for verification)

Upload a File

Please upload a copy of parent/guardian's ID for verification..

Parent/Guardian Consent: By signing below, I agree to the above statement and I verify that all information submitted is correct. *

Player Concussion Waiver (under 18 years old): By signing below, I have received and reviewed the guidelines and materials regarding the warning signs of a concussion. *

Player Liability Waiver

I hereby apply to register or re-register as a soccer player with the Oregon Adult Soccer Association (OASA).

I understand that the OASA-affiliated leagues and tournaments, OASA itself, USASA, USSF, and FIFA all have rules that are applicable to me as a soccer player registered with OASA. I agree to abide by all of these rules.

I agree that the player pass issued to me by the OASA is the property of the OASA and I will surrender my player pass on demand by the OASA.

In consideration of being permitted to participate in any way in OASA, USASA, USSF and FIFA sanctioned events, I, for myself, my personal representatives, assigns, heirs and next of kin:

Acknowledge, agree and represent that I understand the nature of soccer activities and that I am qualified, in good health and in proper physical condition to participate in soccer activities.

Agree that if at any time I believe conditions or equipment to be unsafe, I will immediately discontinue further participation in such activity.

Fully understand that (a) soccer activities involve risks and dangers of serious bodily injury, including permanent disability, paralysis and death; (b) these risks and dangers may be caused by my own actions or in actions, the actions or in actions of others participating in the activity, the conditions under which the activity takes place or the negligence of the “Releasees” named below; and (c) there may be other risks and social and economic losses either not known by me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs and damages I incur as a result of my participation in soccer activities.

Hereby accept and assume all such risks, known and unknown, and assume all responsibility for the losses, costs and/or damages following such injury, disability, paralysis or death, even if caused, in whole or in part, by the negligence of the “Releasees” named below.

Hereby release, discharge and covenant not to sue the OASA, USASA, USSF, their member leagues and tournaments, their respective administrators, directors, agents, officers, volunteers and employees, other participants, referees, any sponsors or advertisers and, if applicable, owners and lessors of the premises on which the soccer activities take place (each of the preceding being considered one of the "Releasees") from all liability, claims, demands, losses or damages on my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations; and I further agree that if, despite my agreement, I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save and hold harmless each of the Releasees from any litigation expense, attorney fees, loss, liability, damage or cost which any Releasees may incur as the result of such claim.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

USASA Waiver

In consideration of being allowed to participate in any way for the United States Adult Soccer Association, Inc., Its Affiliates, Leagues, and Member Teams, its related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1) The risk of injury or illness from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or illness does exist; and,

2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS OF INJURY OR ILLNESS, both known and unknown to me at the time of this agreement, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will bring such to the attention of the nearest official immediately; and

4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the United States Adult Soccer Association, Inc. Its Affiliates, Leagues and Member Teams, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, 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, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Player Consent: By signing below, I agree to the terms of the above statement and I verify that all information submitted is correct. *

*

First Name Last Name

Player's E-mail

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OASA Guest Pass 10-Day Registration Form

Registration Type

Player Information

Items to Upload

Delivery/Pick-up Options

Payment

Liability Waivers

Parent/Concussion Waiver

Player Liability Waiver