Mike Herman and Carter Dyke Memorial Free Soccer Camp Voluntary Activity Participation Waiver, Release of Liability, and Photo Release Form

The individual participants and the parent/guardian of the participants acknowledge that they intend on participating in soccer related events and activities (“Activity”) at the Mike Herman and Carter Dyke Memorial Free Soccer Camp (“Camp”), and state the following:

  1. I understand and acknowledge that this Activity is voluntary.
  2. I understand and acknowledge that this Activity and any related activities, by their very nature, pose the potential risk of significant injury/illness to individuals, who participate in such activities,  and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.
  3. I also realize that the Activity may be strenuous, and that I have the option to seek the advice of a physician before I participate in this Activity.
  4. I understand and acknowledge that some of the injuries/illnesses which may result from participation in the Activity are extremely serious and include, but are not limited to, death and permanent disability.

I voluntarily elect to enter into this Agreement and to participate in, or allow my child/ward to participate in the Activity. I knowingly and freely agree to assume any and all liability and responsibility for any and all potential risks, both known and unknown, which may be associated with my, or my child/ward’s, participation in the Activity and any activities incidental thereto.

I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of to the camp staff.

I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, hereby release and hold harmless Camp, 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 personal injury, bodily injury, wrongful death or loss or damage to person or property incident to my / my child’s involvement or participation in the Activity or those activities incident to and/or associated with the Activity, to the fullest extent permitted by law.

Parent or Guardian Additional Agreement: In consideration of me, or if applicable, my child, whose name and signature appears below, being permitted to participate in the activity, I agree to indemnify and hold harmless Releasees from any claims which are brought by or on behalf of my child or are in any way connected with my child’s participation in the Activity, even if arising from their negligence, to the fullest extent permitted by law.

I agree that if any portion of this Agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. I acknowledge that I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

Parent or Guardian Photo Release: I do hereby consent and authorize Mike Herman and Carter Dyke Memorial Free Soccer Camp to use and reproduce the photographs taken of my child/ward for promotion of Mike Herman and Carter Dyke Memorial Free Soccer Camp.   I further release Mike Herman and Carter Dyke Memorial Free Soccer Camp from any and all claims of damages for libel, slander, invasion of the rights of privacy, or any other claims based on, arising from, or connected with the use of said photographs. No representations have been made to me.