PARENTS NAME: CHILDS NAME: ADDRESS:

PHONE:

FACILITIES USE WAIVER
Newport Mesa Soccer Club
CONTACT INFORMATION

EMAIL:
Waiver of Liability, Assumption of Risk, and Indemnity Agreement
Waiver: In consideration of permission to use, today and on all future dates, the property, facilities, staff, equipment and services of Newport Mesa Soccer Club, I, for myself: my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue The Regents of the Newport Mesa Soccer Club of California, its directors, officers, employees, and agents from liability from any and all claims including the negligence of Newport Mesa Soccer Club resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in activities, classes, observation, and use of facilities, premises, or equipment.
Signature of Parent of Minor	Date	Signature of Player	Date
Assumption of Risks: Physical activity, by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. Newport Mesa Soccer Club has facilities for and provides for activities such as weight lifting, running, aerobic activities, classes and sporting activities. Some of these involve strenuous exertions of strength using various muscle groups, some involve quick movements involving speed and change of direction, and others involve sustained physical activity which places stress on the cardiovascular system.
The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains to 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death.

I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the activities made possible by Newport Mesa Soccer Club. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.

Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD The Regents of the Newport Mesa Soccer Club of California HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney's fees brought as a result of my involvement at Newport Mesa Soccer Club and to reimburse them for any such expenses incurred.

Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.