Santa Cruz Breakers Academy

2019-2020 Breakers FC Open Session and ID Clinics Registration

Information

Clear Current Selection

PARENT/GUARDIAN’S APPROVAL AND MEDICAL RELEASE

Recognizing the possibility of physical injury associated with soccer, and in consideration for the Santa Cruz Breakers Academy (Breakers FC) and its affiliates accepting the registrant for its soccer programs and activities (including ID clinics and tryouts) (the “Programs”), I hereby release, discharge and/or otherwise indemnify the Santa Cruz Breakers Academy, its affiliated organizations and sponsors, their employees and associated personnel, including the owner of fields and facilities utilized for the Programs against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.

My son/daughter has received a physical examination by a physician and has been found physically capable of participating in the Programs. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment, as well as permission to administer over the counter medicine and agree to be responsible financially for the reasonable cost of each assistance and/or treatment.

By typing my name below, I, the parent/guardian of the above-named player, agree to all of the above cited terms and conditions.