Sting Soccer Academy Free Soccer Clinics

Sting Soccer Academy
Free Soccer Clinics - Midland/Odessa
Boys & Girls
Born 2022 - 2016

2 options:
Saturday, December 6th
Saturday, December 20th

Time:
11am - 11:45am - (Birth Years 2022, 2021, 2020)
12pm - 1pm - (Birth Years 2019, 2018, 2017, 2016)

Location:

The Basin Sports Complex

3033 NE Loop 338, Odessa, TX

(located on the campus of UTPB)

Contact:
WTX Academy Director
Kevin Munoz
kevinmunoz.ttm@gmail.com

Player Name

First NameLast Name

Gender

DOB

Date

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Session attending

Waiver of Liability and Release Form

This form must be completed for each soccer player, or other Club program participant, and, if the player or participant is under 18-years old, must be signed by the player's parent or legal guardian.&#13;&#10;&#13;&#10;No other Club program participant, will be allowed to participate in Sting Soccer Organization's training sessions, scrimmages, or games without this form, properly executed, and on file.&#13;&#10;&#13;&#10;I, the undersigned, in consideration for my voluntary participation in Sting Soccer Training Sessions, Scrimmages, and/or Games, do hereby willfully acknowledge that my signature below attests to my understanding and agreement that:&#13;&#10;&#13;&#10;My player status will be kept in good standing. I will not compromise myself in such a way as to do harm to the Sting Soccer Organization or its training sessions, scrimmages and/or games, knowing that players may be dismissed from participation, with possible loss of payment or dues, for violent conduct or unsporting behavior on or off the field of play. I agree to pay for any and all damages to any property or indemnities caused by me willfully, negligently, or otherwise.&#13;&#10;&#13;&#10;Soccer is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards associated with my participation in the sport. I am in proper physical condition to participate in soccer practices and games and have no illness, disease or existing injury or physical defect that would be aggravated by my participation. I will inform a coach or staff member if this status changes. I further acknowledge that this risk may involve loss or damage to me or my property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I have a current medical consent form in force. I will wear shinguards, properly- fitted and appropriate shoes, and other protective equipment (e.g., mouth-pieces), as provided by soccer rules, to all events.&#13;&#10;&#13;&#10;Sting Soccer Club does not have personal injury insurance that covers my participation. Therefore, I should have a current, active, personal injury insurance policy in force, which covers my participation. Under any condition, I am responsible for any and all medical expenses arising from my participation, both in practices and games and while travelling to and from these events. I have the right and responsibility to inspect the equipment and facilities prior to events and, if I believe that anything may be unsafe, I will advise the coach or supervisor of the condition and may refuse to participate. Participation assumes&#13;&#10;&#13;&#10;In the event of an emergency, I authorize the Organization's staff or representatives to seek necessary medical treatment for my child. I understand that I am responsible for all medical costs incurred.&#13;&#10;&#13;&#10;I authorize my photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising), television, video, or radio coverage of the Sting Soccer Organization's training sessions, scrimmages, and/or games.

Parent/Guardian Name

First NameLast Name

For those individuals under the age of eighteen (18) years (minor):As the parent and natural guardian or legal guardian of the participant, I hereby agree to the foregoing Waiver of Liability and Release for, and on behalf of, the participant (player/minor) named above. I hereby bind myself, the minor, and all other assigns to the terms of the Waiver of Liability and Release. I represent and certify that I have the legal capacity and the authority to act for, and on behalf of, the minor in the execution of this Waiver of Liability and Release.

Signature

Sting Soccer Academy Free Soccer Clinics - Midland/Odessa