Medical and Liability Waiver

Medical and Liability Waiver

Elite Kickers Soccer (EKS)

Before participating in any practices, games, or other activities under the auspices of Elite Kickers Soccer (EKS), you acknowledge the inherent risks associated with playing soccer and agree to the terms outlined below.

Acknowledgement of Risk

I, the undersigned, acknowledge that soccer is a physically demanding sport that involves inherent risks and dangers. These risks include, but are not limited to, collisions with other players or objects, falls, and the potential for serious physical injury, including fractures, brain injuries, and other catastrophic injuries. I understand that these risks may arise from my own actions or inactions, the actions or inactions of others, the conditions of the facilities, equipment, or areas where soccer activities are conducted.

Medical Authorization

I hereby give my consent to Elite Kickers Soccer (EKS) and its authorized representatives to obtain medical care from any licensed physician, hospital, or clinic for the player named herein at such times as either parent or the player is unable to consent to such care. It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required and is given to provide authority and power to render care which the aforementioned physician in the exercise of their best judgment may deem advisable. I agree to be fully responsible for any and all costs incurred as a result of said treatment.

Safe Sport Commitment

Elite Kickers Soccer (EKS) is committed to the safety and well-being of all players. As part of this commitment, EKS adheres to the Safe Sport Act, which is designed to protect athletes from abuse, including emotional, physical, and sexual abuse, in sports. By signing this waiver, I acknowledge that EKS has provided information on how to recognize and report abuse and that I am aware of the standard procedures for addressing these concerns within the club.

Report A Concern

How to Report a Concern: To make a report, either fill and submit the form here, or call (312) 528-7004 to leave a voicemail. Please provide as much detail in your report as possible, including contact information, should you wish to be contacted concerning your report. U.S. Soccer does not retaliate and does not tolerate retaliation against any individual who makes a report in good faith. Please see below for more information.

If you have a general message or concern not related to the foregoing, please submit your message via the U.S. Soccer Contact Us page.

What can I report to the integrity hotline?

  • Some examples include, but are not limited to:
  • Potential violations of the SafeSport Code/participant safety policies
  • Potential violations of law or policy
  • Anti-doping violations
  • Allegations of match fixing
  • Allegations of referee misconduct and/or misconduct or assault toward a referee
  • Concerns regarding your local soccer club, state association, or national member organization

Release and Waiver of Liability

In consideration of being allowed to participate in any way in Elite Kickers Soccer (EKS) athletic sports programs, related events, and activities, I, the undersigned, acknowledge, appreciate, and agree that:

  • I release, waive, discharge, and covenant not to sue Elite Kickers Soccer (EKS), its affiliated clubs, their respective administrators, directors, agents, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (releases) from all liability to the undersigned, his/her personal representatives, assigns, heirs, and next of kin for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the undersigned, whether caused by the negligence of the releases or otherwise while the undersigned is participating in such activities.
  • I agree to indemnify and hold harmless the releases from any loss, liability, damage, or cost they may incur due to my participation in said activities, whether caused by the negligence of releases or otherwise.
  • I understand that this release and waiver of liability includes any claims based on the actions, omissions, or negligence of Elite Kickers Soccer (EKS), its affiliates, members, coaches, agents, employees, and volunteers, including any infectious diseases.

Consent for Publicity

I further grant Elite Kickers Soccer (EKS) the right to photograph and/or videotape me and further to use my name, face, likeness, voice, and appearance in connection with exhibitions, publicity, advertising, and promotional materials without reservation or limitation. The releases herein are given perpetually.

 

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