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The 2026 Ice Breaker Soccer Tournament has teamed up with member of the American Massage Therapy Association (AMTA) to provide pre/post event sports massage treatments to all participating athletes desiring to get worked on. We are also inviting all parents, siblings and affiliated spectators who might enjoy a treatment as well.

This service is provided free of charge to everyone Saturday Feb. 14th and Monday Feb. 16th. This service will be provided at the tournament Headquarters under open/public outdoor tents at Sandtown Park 600 N Bluff Street St. George, UT. 84770. 

Private treatments may be scheduled for Sunday February 15th (for a fee) at the tournament headquarters. please see this link for Therapists bios, phone and email. 

https://www.usucs.com/sports-medicine-lmts


Please do not provide any contact information for anyone under the age of 13 (email, phone etc.)

Outside Sports Massage Adult/Minor Consent

1. Authorization & Policy I, the undersigned, am the parent or legal guardian. I authorize the therapist to provide sports massage (stretching, compression, myofascial release). I understand all services are performed fully clothed in an outdoor public setting in full view of the public and event staff.

2. Public & Fully Clothed Treatment I understand and agree to the following conditions regarding the treatment environment:

  • Fully Clothed: All services will be performed while the adult/minor remains fully clothed in athletic wear (e.g., gym shorts, leggings, t-shirts). No clothing will be removed or adjusted.
  • Public Visibility: All treatment will be rendered in an open, outdoor setting in full view of the public, event participants, and staff, ensuring compliance with Utah state safety and transparency requirements.
  • Required Presence: As guardian, I agree to remain in the immediate vicinity of the massage station for the entire duration of the treatment(s) or I agree to give consent to another attending adult such as a coach, manager, family member or friend to attend in my behalf. 
  • Right to Stop Service: Both the adult/minor and practitioner have the right to stop or adjust any services at any time, for any reason.

3. Client Rights & Professional Boundaries (Utah HB 278)

  • I acknowledge my right to request the provider’s first name, last initial, and license type.
  • I acknowledge my right to request information on how to report complaints to the Utah Division of Professional Licensing (DOPL).
  • I understand that the therapist will strictly avoid all sensitive areas (genitals, anus, and breast tissue) as defined by Utah law.
  • I understand that treatment may consist of work done on the feet, legs, gluteal muscles (buttocks), back, arms, hands and head. I understand that I have the right to request the practitioner to skip over treatment to any of these areas. 
  • I understand that if I experience any pain or discomfort during the session, that I will immediately inform the practitioner. 

4. Informed Consent & Health Disclosure I have been given the opportunity to address questions with the Licensed Massage Therapist and have provided verbal consent to the treatment plan. I confirm the adult/ minor has no medical conditions (e.g., recent fractures, contagious skin conditions, or acute injuries) that would make massage therapy unsafe.

5. Electronic Signature I agree that this digital signature is the legally binding equivalent of my handwritten signature. 


All Massage Therapists (LMT's) are professionally licensed with the State of Utah and are Members of the American Massage Therapy Association (AMTA).

All Massage Therapists and Sports Medicine providers are Independent contractors and are not employed or affiliated with the Ice Breaker Soccer Tournament or US Utah Comp Soccer. They are invited professionals to add benefit and professional services to the wonderful athletes attending our events. Each Professional Massage Therapist and Sports Medicine provider will take full responsibility for the services they provide.  

First Participants Name
First Name*
Last Name*
Phone*
Select Gender
First Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
First Participants Signature*
Second Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Third Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Fourth Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Fifth Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Sixth Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Seventh Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Eighth Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Ninth Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
Tenth Participants Name
First Name*
Last Name*
Select Gender
Participants Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
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*
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact
First Name*
Last 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.


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*
Last Name*
Relationship*
Phone*
Select Gender
Parent or Guardian's Date of Birth*
Date of Birth
Information
Team Name *
Team birth year (2013, 2015, etc) *
Coaches Name *
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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