UPSL Soccer Match Participation Waiver

Spring/Summer & Fall Season 2021

During COVID-19 pandemic


This form must be completed for each soccer player (participant) and, if the player is under 18-years old, must be signed by the player’s parent or legal guardian. No player will be allowed to participate in any UPSL match during the Spring/Summer and Fall 2021 season without this form, properly executed, and on file with the UPSL.

In signing this waiver I am acknowledging that my participation is entirely voluntary. I also acknowledge that participating involves risk of injury or illness, including but not limited to COVID-19. As a condition of participating I agree to hold harmless and covenant not to sue the UPSL, the Directors & Officers of the UPSL, the UPSL Division Manager, my team, the directors & officers of my team, and my team coaches and trainers.

In signing this waiver I also acknowledge that I have both read the UPSL COVID-19 Safety Protocols, and will abide by those safety protocols, including (but not limited to) understanding that I should not participate if I am living at home with elderly or vulnerable relatives or other individuals, either elderly or with underlying health conditions.

I, the undersigned, in consideration for my voluntary participation in UPSL matches in the Spring/Summer and Fall 2021 Seasons, do hereby willfully acknowledge that my signature below attests to my understanding and agreement that:

Soccer is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards associated with my participation in the UPSL matches. I am in proper physical condition to participate in the UPSL matches, and have no illness (including but not limited to COVID-19), disease or existing injury or physical defect that would be aggravated by my participation, or would put others participating at risk. I will inform my coach if this status changes.

I further acknowledge that my participation may involve loss or damage to me or my property, injury, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I will wear shin-guards, properly fitted and appropriate shoes, and I will wear a mask when sitting on the team bench.

I understand that the player insurance policy provided with USASA player registration is limited in scope and has a maximum coverage amount of $25,000. 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, and while travelling to and from these matches, if the player insurance policy and/or my own personal injury insurance policy does not cover them. I have the right and responsibility to inspect the equipment and facilities prior to the sessions and, if I believe that anything may be unsafe, I will advise my coach of the condition and may refuse to participate. Participation assumes consent and assumption of all risks.

I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue UPSL, the Directors & Officers of the UPSL, my UPSL Division Manager, my team, the directors & officers of my team, and my team coaches and trainers, from any and all liability incurred in the conduct of, and my participation in, the UPSL matches forming the Spring/Summer and Fall 2021 Seasons. I have completely read this document and fully understand its contents. I acknowledge that I have given up substantial rights by accepting and executing this document and that I do so voluntarily. My signature attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns.




First Participant Name

First Name*

Middle Name

Last Name*
First Participant Date of Birth*
First Participant Information

Participant Team *

Participant Coach *
First Participant Signature*
Parent or Guardian's Email Address


Confirm Email*
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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*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Participant Team *

Participant Coach *
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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