Participant & Parent/Guardian Agreement Acknowledgement of Risk
As the parent or legal guardian of a participant in UYSA-MYSA programs, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor or Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.
I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the USYSA and the MYSA, its affiliated organizations, and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the USYSA and MYSA accepting the registrant for its soccer programs and activities(the “program”), I hereby release, discharge and/or otherwise indemnify the USYSA and MYSA, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant’s participations in the Program.
I wish to participate in youth soccer, and more particularly MYSA TOPSoccer Program. In connection with my participation, I acknowledge the risk of possible physical harm to me as a result of my participation is increased because of my disability which I sustained in the past, and for which I have received medical attention. While there is no immediate danger to me, I am told that due to my disability, strenuous collision type activities, such as soccer, could render me more susceptible to future problems than might be expected. I understand that if the participant has Down syndrome, a full radiological examination to establish the absence of Atlanto-axial Instability is needed.
I have considered participation in activities other than soccer and reviewed those considerations with my parents/guardian and physician. I have discussed this situation with my parents, and we understand the potential danger of participating in soccer. Notwithstanding that my participation in youth soccer constitutes more risk to me than it does to other athletes; I nevertheless wish to participate in youth soccer. In making this decision, I am aware of the value of participating in TOPSoccer in my life and choose to continue my participation in order to take advantage of those values. In weighing the risk of potential injury to myself both now and in the future, I wish to exonerate and save harmless MYSA TOPSoccer their agents, servants, and employees, from any liability as a result of an injury or death relating to my disability and not to any injury that may occur in the future which is unrelated to my previous disability. I executed this agreement freely, fully intending to be bound by same.