***SCREENSHOT INFORMATION FOR CONVENIENCE OF RECORD***

The Simba Soccer Camp will take place on the following dates:

SESSION I: June 24-28

SESSION II: July 8-12

SESSION III: July 15-19

TIME: 10:00 AM to 11:30 AM

CHECK-IN: 9:45 AM
ARRIVE FOR PICK UP BY: 11:25 AM

LOCATION: Kadish Park (800 E North Ave) **There is additional parking along Garfield Ave. if the COA parking lot is full. 

*All players are expected to arrive prepared and properly dressed for soccer camp. 

WHAT TO BRING?

Shorts, socks, shoes, water bottle, & soccer ball once received. A snack will be provided each day but please make sure campers have a healthy breakfast daily.

We are a community, if you would like to donate healthy snack items please feel free to contact us! We thank you all in advance.

Parent/Guardian Information

Emergency Information

WAIVER & RELEASE FORM

MILWAUKEE SIMBA SOCCER CLUB, INC.

RELEASE OF LIABILITY FOR MINOR PARTICIPANTS

READ BEFORE SIGNING:

I hereby give my approval and consent to the participation of my child in the Milwaukee Simba Soccer Club, Inc’s (“Club”) Summer Camp.

In consideration of said participation, I hereby acknowledge and agree that:

The risk of injury and/or illness (including COVID-19) from the activities involved in this Club program is significant, including the potential for permanent disability or death, and while particular rules, equipment, and personal discipline may reduce these risks, they still exist;

I willing and knowingly, for myself, spouse, Minor, and Minor’s legal guardian, if other than myself, assume all such risks, both known and unknown, even if arising from the negligence of others, and assume full responsibility for Minor’s participation;

I willingly agree to comply with the Club’s stated and customary terms and conditions for participation.  If I have any concern(s) for Minor’s readiness for participation or in the program itself, I will remove Minor from participation immediately and bring such concern(s) to the attention of the Club;

I willing and knowingly, for myself, spouse, Minor and Minor’s legal guardian, if other than myself, and our heirs, assigns, personal representatives, and next of kin, hereby release and hold harmless the Club, its directors, officers, officials, agents, employees, volunteers, 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 injuries, illness, disability, death or loss or damage to person or property incident or in any way related to Minor’s involvement or participation in these Club programs, events or activities, whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law. 

I willing and knowingly, for myself, spouse, Minor, and Minor’s legal guardian, if other than myself, and our heirs, assigns, personal representatives, and next of kin, hereby indemnify and hold harmless all of the above Releasees from any and all liabilities incident to Minor’s involvement or participation in the Club or Club programs, events or activities, whether arising from the negligence of Releasees or otherwise, to the fullest extent permitted by law.

I certify that Minor is physically fit and able to take part in all Club programs, events, and activities and have listed below any allergies or medical conditions, including food allergies, that might affect Minor’s participation in Club programs, events, or activities. 

I have read this Waiver and Release Form, fully understand its terms, and sign it freely and voluntarily without any inducement.

PHOTO/MEDIA RELEASE FORM

Milwaukee Simba SC has my permission to use my or my child’s photograph/video publicly to promote the Club. I understand that the images may be used in print publications, online publications, presentations, websites, and/or social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Milwaukee Simba SC, Inc. and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.