Spring 2019 SESSION

When: Wednesdays - March 13 - April 24 (no class March 27)

6:00pm-7:00pm – If your athlete attends our Kid's or Classic Teen Social.

7:00pm-8:00pm – If your athlete attends our Aspie Teen or Adult Social

CONTACT US WITH QUESTIONS ABOUT PLACEMENT FOR YOUR ATHLETE

CONFIRMATION OF YOUR ATHLETES TIME WILL BE COMMUNICATED BY MARCH 6th

Cost: $65 - includes T-shirt!

Location: McGrath Elementary

5288 Todd St. Grand Blanc, 48439

The following must be received by March 6th to attend, NO EXCEPTIONS:

Completed Registration Form and Signed Waiver

Payment In Full (online payment available on POWER Soccer Registration Page). Cash or check made payable to ASRC. Can be dropped off to us in secure drop box. We are located at G4476 S. Dort Hwy, Burton, 48529 **Small credit card fee applies**

Refund Policy: Registrants may request a refund of ½ their fee within 3 days of class starting. No refunds given after this period.

Parent Information

Participant Information

Autism Support & Resource Center (ASRC)

WAIVER, RELEASE OF LIABILITY, ACKNOWLEDGEMENT OF RISK AND

INDEMNITY AGREEMENT            

In consideration of being permitted to participate in Autism Support & Resource Center (ASRC) activities in any capacity, I, for myself and for my heirs, next of kin, assigns and personal representatives:

1. Understand that my execution of this Waiver is a prerequisite for my participation and/or the participation of my child(ren) or ward of whom I am the parent or guardian (“my child”), in the Event.
2. Understand that I am solely responsible for the health and safety of myself and/or my child, and represent that I and/or my child is in good health and physically capable of participating in this Event. If at any time during my and/or my child’s participation in the Event I feel like my and/or my child’s physical condition no longer allows me and/or my child to participate or I believe the Event becomes unsafe, I will immediately stop my and/or my child’s participation. I will abide by all Event rules and will be responsible for ensuring that my child will do so.
3. Acknowledge and understand fully that there are risks and dangers of serious bodily injury and death that could result from my and/or my child’s participation in the Event. I understand that in order to be allowed to participate in the Event, I agree to fully accept and assume all risks and all responsibility for any injury, losses and damages to person or property that I and/or my child may incur as a result of my and/or my child’s participation in the Event.
4. Hereby agree to release and hold harmless the ASRC, the owner or possesor of the venue, and their past and present affiliates, assigns, successors in interest, agents, servants, employees, volunteers, participants, officers, directors and sponsors, and all government and public entities including, but not limited to, the State, County and local municipalities where the Event takes place (collectively the “Released Parties”).
5. Understand and agree that this release will have the effect of releasing, discharging, waiving, and forever relinquishing any and all actions or causes of action that I and/or my child may have, whether past, present or future, whether known or unknown, arising from, resulting from, or in connection to the Event. This release constitutes a complete release, discharge and waiver of any and all actions or causes of action that I and/or my child may have against the Released Parties, including but not limited to any claims for personal injury, property damage, or wrongful death and including but not limited to any injuries resulting from negligent actions or omissions.
6. Irrevocably authorize the ASRC to use my and/or my child’s recorded voice, image and likeness in any medium including, without limitation, video, photograph, film, tape, and digital medium, for any lawful purpose. I understand that neither I nor my child will receive any compensation for the use of my and/or my child’s recorded voice, image and likeness in promotional materials and waive rights to any compensation now or in the future.
7. Have carefully read this Waiver and fully understand its contents. I am aware that this is a release of liability and I sign of my own free will. I intend this to be a complete and unconditional release of all liability to the greatest extent allowed by the law, even though that liability may arise from the negligence or carelessness of the Released Parties listed above, and I agree that if any portion of this agreement is held to be invalid, the remaining portion of the agreement shall continue to be in full force and effect.

PARENTS/GUARDIANS OF POWER SOCCER PLAYERS MUST REMAIN IN THE GYM AND/OR PARTICIPATE FOR THE DURATION OF THE PROGRAM