*Player's Name: Player's E-Mail
*Address:
*City: *Zip:
*Phone:
*Birthdate:
*2007-08 Grade:
School:
Gender: Team:
Male
Height: Weight:
Previous Team: Position:
Father's Name: Daytime #: E-Mail Address
Mother's Name: Daytime #: E-Mail Address
Medical Insurance Carrier:
RELEASE AND WAIVER OF LIABILITY
The player and his/her parents acknowledge that soccer is a contact sport which involves the possible risk of injury. In exchange for the opportunity to participate on the Club’s teams, the Player and his/her parents hereby release, and waive any liability against, the Chicago Wind LLC, doing business as the Chicago Wind Soccer Club, its coaches, trainers, directors, officers, managers, employees,agents or volunteers acting on behalf of the Chicago Wind Soccer Club from any and all liability relating to or in any manner arising out of the Player’s participation on the Chicago Wind Soccer Club; the Player’s use of any contracted fields or facility, or any part of it, including but not limited to (1) the soccer arenas, grandstands, restrooms, and concessions, (2)any part of the facility which the Player is not authorized to use, and (3) any part of the facility leased to third parties; the Player's use of any field or facility owned, leased or used by ether the Chicago Wind LLC or the Player's participation in any game, tournament, camp, clinic, practice while a member of the Chicago Wind. The Player and his/her parents or guardian hereby agree to indemnify and hod harmless the Chicago Wind LLC doing business as the Chicago Wind, its coaches, trainers, directors, and managers, its directors, shareholders, officers, agents and employees, from any suit or legal proceedings, including but not limited to attorneys fees, with respect to the Player’s participation on the Club’s teams, use of facility or any other field or facility used by the Player. This release shall be binding upon my personal representatives, heirs and assigns.
*Check box to accept release: