Collegiate Futbol Academy, LLC Waiver, Release and Authorization

IN CONSIDERATION OF my child/player/ward/minor named below, being allowed to participate in any and all ways in the Collegiate Futbol Academy LLC’s, August 12-15, 2024 soccer Academy/Clinic, related events and activities, the undersigned acknowledges, appreciates, accepts and agrees with this Waiver, Release and Authorization and it's entire content, as follows:

My daughter/child/player/ward/minor has permission to fully participate in this clinic/academy. I further hereby acknowledge and fully understand it is possible my child may face injury, death and/or health risks by her participation in this soccer academy/clinic and I assume these risks. The risks of injury and illness to my child from the activities involved in these programs are significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; Collegiate Futbol Academy, LLC cannot enumerate every risk. I further acknowledge as the Parent/Guardian I am in the best position to decide whether my child should attend this academy/clinic, and state she is and hereby agree to do so. FOR MYSELF, SPOUSE, AND CHILD/MINOR, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, even if arising from the negligence or gross negligence of the Releasees, named herein, or others, and assume full responsibility for my minor child’s participation; and, 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 minor child from the participation and bring such attention of the nearest official immediately; and, as the parent/guardian of the player/child/ward/minor named above I hereby give permission for my child to receive emergency medical, ambulance care, surgical treatment and hospitalization if necessary. I understand that every attempt will be made to contact me, before taking this action.

I acknowledge and understand Collegiate Futbol Academy, LLC is a private organization which is independent and separate from Austin Preparatory High School. I myself, my spouse, my child/player/minor, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY ABSOLUTEY, WAIVE, RELEASE AND HOLD HARMLESS Collegiate Futbol Academy, LLC, its directors, owners, officers, officials, agents, representatives, employees, staff, coaches, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and any individuals associated with the organization in any manner, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL, regardless of severity, INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property incident to my minor child’s direct or indirect involvement or participation in these programs, including but not limited to Covid-19, heat-related illnesses, dehydration, asthma and/or allergies/food allergies, whether or not arising from the negligence or gross neglience of the Releasees named or others, to the fullest extent permitted by law.

I, for myself, my spouse, my child/minor, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY FULLY and ABSOLUTELY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities whatsoever, incident to my minor child’s, direct or indirect, involvement or participation in these programs, even if arising from their negligence or gross negligence, to the fullest extent permitted by law. I, the parent/guardian, assert that I have explained to my child/ward/player/minor: the risks of the activity, her responsibilities for adhering to the rules and regulations, and that my child/ward/player/minor understands this agreement and her responsibilities.

I AGAIN ACKNOWLEDGE I UNDERSTAND THERE IS A RISK OF INJURY TO MY CHILD AS A RESULT OF RESULT OF THESE SOCCER ACADEMY/CLINIC ACTIVITIES, AND KNOWINGLY AND VOLUNTARILY ASSUME ALL RISK OF SUCH INJURY. By signing the form below. I attest and certify my minor child has been cleared by a medical professional and/or doctor to full participate in this soccer camp. I further agree to be, and will be, absolutely financially responsible for any medical attention or services needed or provided before, during, or after the soccer academy as a direct or indirect result of the player’s attendance and/or participation in the soccer clinic/academy.

I further hereby give permission for the staff at the Academy/Clinic to apply sunscreen to my child if they request assistance in doing so. I also acknowledge photos may be taken of the soccer players during the week for future Soccer Academy promotional purposes and I authorize and give my permission to do so of my child/player/daughter/minor but only for the stated purpose herein.  

You are encouraged to seek an attorney’s advice prior to signing. You may not however, change the language of this form and any additions or deletions you make to this form will have no effect. It is my understanding and intent the electronic signature below shall be, and serve as, my original signature and be legally fully binding upon execution. I, FOR MYSELF, MY SPOUSE, AND CHILD/WARD/PLAYER/MINOR, HAVE READ THIS RELEASE OF LIABILITY, WIAVER, AUTHORIZATION AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY, IN GOOD FAITH, VOLUNTARILY WITHOUT ANY INDUCEMENT and NOT UNDER DURESS. I hereby complete all the information below honestly, truthfully and accurately and execute, affix, and sign my signature below, in the same manner, certifying and attesting it is my own, under the pains and penalties of perjury this day:


Player / Child's Name
First Child / Player / Participant Name

First Name*

Middle Name

Last Name*

First Child / Player / Participant Date of Birth*
First Child / Player / Participant Signature*
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Parent or Guardian's Email Address


Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Doctor / Medical Information

Physician's Name *

Physician's address and phone number *

Medical or Physical Restrictions *

Food or Medication Allergies: *

Please identify any medical condition or history which would require special attention: *
Health Insurance Information

Health Insurance Carrier *

Policy Number *

Policy Holder Name *
Daily Pick Up Information

Please provide the name(s) of the any and all persons/parents/guardians authorized to pick up your player at the conclusion of each day: *
My daughter is self-driven, has a family vehicle, a valid Massachusetts Drivers License and will drive herself home each day.*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree they and the minor are subject to all the terms of this document, as set forth above.

By signing below the parent or court-appointed legal guardian agrees that they are also 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 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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