Player Wavier

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Jersey City & Hoboken | Intentional Sports Programming Rooted in Social-Emotional Learning |

Today's Date*

Location/ Name of Event*

Participant First and Last Name*

Participant Current Age*

Participant Date of Birth*

Parent/ Guardian First + Last Name*

Parent/ Guardian Primary phone number*

Parent/ Guardian Email*

Emergency Contact Name + Relationship + Phone number*

1. Assumption of Risk I, the undersigned, am the parent or legal guardian of the Participant named above. I understand that soccer is a physical, contact sport and that participation in training sessions, drills, games, and recreational play involves inherent risks, including but not limited to: trips, falls, collisions with other players or equipment, muscle strains, weather-related illness, and serious injury such as concussions, broken bones, or permanent disability. I voluntarily assume all risks associated with the Participant's involvement in Doza Sports activities. 2. Primary Medical Insurance Requirement I certify that the Participant is covered by valid primary health/medical insurance. I accept full financial responsibility for all medical expenses, co-pays, and deductibles incurred as a result of participation in Doza Sports activities. 3. Release & Waiver of Liability In consideration of being permitted to participate, I hereby release, waive, and discharge Doza Sports LLC, its owners, coaches, volunteers, employees, and the property owners where training occurs from any and all claims of negligence, accidents, or illnesses arising from participation in soccer training. This release applies under the laws of the State of New Jersey. 4. Indemnification I agree to indemnify and hold harmless Doza Sports LLC and its representatives from any and all claims, actions, costs, and expenses (including attorney fees) arising out of the Participant's involvement in training. In the event of an emergency and if I cannot be reached, I grant permission to Doza Sports LLC staff to seek and authorize medical treatment for the Participant. I agree to be responsible for all costs associated with such treatment. 6. Understanding of Program I understand that Doza Sports programming focuses on youth athletic development, skill-building, and social-emotional learning through the sport of soccer and or flag football and complementary activities. I acknowledge that participation is voluntary and that Doza Sports staff are trained coaches committed to child safety and development.*

Yes

I grant Doza Sports LLC the right to take and use photos or videos of the Participant for promotional purposes (social media, website, marketing materials, etc.) without further compensation. [ ] Check here if you OPT OUT of the Photo & Video Release*

Yes

ACKNOWLEDGMENT & SIGNATURE [ ] Please check this box to confirm: I have read this waiver carefully, fully understand its terms, and acknowledge that I am voluntarily giving up substantial legal rights by signing it of my own free will. Electronic Signature Agreement: I understand and agree that my electronic signature below carries the same legal weight and enforceability as a traditional signature on paper. *

Yes

ACKNOWLEDGMENT & SIGNATURE Please type your full name to confirm: I have read this waiver carefully, fully understand its terms, and acknowledge that I am voluntarily giving up substantial legal rights by signing it of my own free will. Electronic Signature Agreement: I understand and agree that my electronic signature below carries the same legal weight and enforceability as a traditional signature on paper. *

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Player Wavier

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