EOU Soccer Academy
Name
First Name
Last Name
Birthday
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Month
-
Day
Year
Date
Age
Guardians Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact
Please enter a valid phone number.
Liability Waiver: The Oregon Tort Claims Act (ORS 30.280 to 30.300) permits Eastern Oregon University to accept responsibility only for the acts of its officers, employees, and/or agents. Eastern Oregon University is prohibited from accepting any liability for the acts, omissions, and conduct of persons participating in activities. The participant shall indemnify, defend, and hold harmless the State, Eastern Oregon University, its officers, employees, and agents from all claims, suits, or actions of any nature arising out of participation in these activities, other than negligent acts of Eastern Oregon University, its officers, employees and/or agents. I acknowledge that I am participating in this activity at my own risk. I understand that, due to the inherent nature of the activity, there is a risk of injury in participating in these activities. By signing below I acknowledge that I have read the risks above and understand the assumption of general risk and agree to the conditions listed above.
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Agree
Disagree
EOU Informed Consent: Participant agreed to abide by the following rules:- I agree to follow safety and other instructions provided by the Coach/Clinician/Coordinator/Trainer- I agree to share in the responsibility for my own safety and not endanger others who are participating in the activity- I agree to operate and use equipment, tools, and materials in a safe manner. Failure to do so may result in being asked to leave the property.- I will immediately report all injuries to the Coach/Clinician/Coordinator/Trainer- I agree to refrain from the use of alcohol or drugs during the activity- I understand that participation in this activity is voluntary- I acknowledge that I have the physical capacity necessary to engage in the described activity above.- In case of an emergency, accident or illness, I give my permission to be treated by a professional medical person and if necessary, be admitted to a hospital.- I agree to be the party responsible for all medical expenses incurred on my behalf.- I agree not to shelter firearms on my possession or within a vehicle in route to during, and returning from an activity. - Failure to sign this form will result in inability to participate.
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Agree
Disagree
Location is the EOU soccer grass field which is east of Peggy Anderson Softball field.
Payment of $75 will be accepted in card, cash or check day of camp Aug. 9th and will include a T-shirt.
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