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UPSL Soccer Match Coach Participation Waiver

Spring/Summer Season 2021

Fall Season 2021

During COVID-19 pandemic

This form must be completed by each team coach (participant). No coach will be allowed to participate in any UPSL match during the Spring/Summer 2021 season or the 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 United Premier Soccer League (UPSL), the Directors & Officers of the UPSL, and the United States Adult Soccer association (USASA).

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 with underlying health conditions.

 

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

Soccer is a physical sport that involves the risk of injury. I assume all risks and hazards associated with my participation as a coach in the UPSL matches. I am in proper physical condition to participate in coaching 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 UPSL Division Manager 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 understand that 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 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 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, and the USASA, from any and all liability incurred in the conduct of, and my participation in, the UPSL matches forming the Spring/Summer 2021 Season and the Fall 2021 Season. 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.

December 2, 2021

First Participant Name

First Name*

Middle Name

Last Name*

Phone*
First Participant Date of Birth*
First Participant Information

Participant's Team *
First Participant Signature*
Second Participant Name

First Name*

Middle Name

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

Participant's Team *
Third Participant Name

First Name*

Middle Name

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

Participant's Team *
Fourth Participant Name

First Name*

Middle Name

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

Participant's Team *
Fifth Participant Name

First Name*

Middle Name

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

Participant's Team *
Sixth Participant Name

First Name*

Middle Name

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

Participant's Team *
Seventh Participant Name

First Name*

Middle Name

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

Participant's Team *
Eighth Participant Name

First Name*

Middle Name

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

Participant's Team *
Ninth Participant Name

First Name*

Middle Name

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

Participant's Team *
Tenth Participant Name

First Name*

Middle Name

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

Participant's Team *
Parent or Guardian's Email Address

Email*

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*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Participant's Team *
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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