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CHATTANOOGA FOOTBALL CLUB 
CONSENT AND RELEASE OF LIABILITY

I, the below named player, agree to abide by the rules of Chattanooga Football Club and all other affiliated organizations. Recognizing the possibility to physical injury associated with soccer/athlete training, as more fully outlined below, and in consideration for Chattanooga Football Club and its affiliates accepting the player for its soccer/athlete Chattanooga Football Club Program, I hereby release, discharge, and/or otherwise indemnify Chattanooga Football Club and all other affiliated organizations, their employees and other associated personnel (hereinaſter the “released parties”), against any claim by or on behalf of the registrant as a result of the registrants participation in the program and/or being transported to or from the same, which transportation I hereby authorize.

I, the below named player, agree to the following:

I agree that if I engage in this recreational activity, it is done at my own risk and I assume the risk of any and all injury and/or damage while engaging in said recreational activity. My assumption of risk includes, without limitation, injuries from uneven or irregular playing surfaces, injuries from contact with equipment or from equipment failures, injuries from physical contact with other players or injuries incurred while performing the physical activities inherent in participation in this activity. I agree that I am voluntarily participating in the aforementioned activities and using the facilities and premises and assume all risk of injury, illness, damage or loss to me of my property that might result, including, without limitation, any loss or theſt of any personal property.

I agree on behalf of myself (and all your personal representatives, heirs, executors administrators, agents and assigns) to release and discharge the released parties from any and all claims or causes of action (known and unknown) arising out of the negligence of the released parties, whether active or passive.

This waiver and release of liability includes, without limitation, injuries which occur as a result of (a) my use of any equipment or facilities which may malfunction or break, (b) improper maintenance of any exercise equipment or facilities, (c) negligent instruction or supervision, and (d) slipping and falling for any reason, including negligent inspection or maintenance of its facility.

By execution of this agreement I hereby agree to indemnify and hold harmless the released parties from any loss, liability, damage or cost the released parties may incur due to your participation. I further expressly agree that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by law in the State of Tennessee and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY AND EXPRESS ASSUMPTION OF RISK AND INDEMNITY AGREEMENT. I AM AWARE AND AGREE THAT BY EXECUTING THIS WAIVER AND RELEASE, I AM GIVING UP MY RIGHT TO BRING LEGAL ACTION OR ASSERT A CLAIM AGAINST THE RELEASED PARTIES FOR THEIR NEGLIGENCE OR FOR ANY DEFECTIVE PRODUCT ENCOUNTERED DURING PARTICIPATION. I HAVE READ AND VOLUNTARILY SIGNED THE WAIVER AND RELEASE AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE.

Consent for Medical Treatment
As the participant in Chattanooga Football Club activities, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

Consent for Use of Subject for Promotion-Advertising
In addition, as the participant in Chattanooga Football Club activities, I hereby give my consent for photographs, pictures, video, or any other form of subject content, of my dependent to be utilized in promotion, advertising or any other type of marketing for Chattanooga Football Club.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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