
Youth Soccer Club in Wellen Park, Florida
This waiver applies to the registered player’s participation in the Turkey and Turf Thanksgiving Soccer Camp operated by Southwest Florida Surge Athletics LLC (“Surge”). PARTICIPATION AND ACKNOWLEDGMENT OF RISKS I am the registered player’s parent or natural guardian and have authority to consent to the player’s participation. I understand that soccer involves physical exertion, running, changes of direction, contact with other participants, and contact with balls, goals, equipment, and playing surfaces. Risks include falls, collisions, sprains, fractures, concussions, heat-related illness, other serious injuries, and death. Some risks are inherent in the activity and remain even when reasonable care is used. I voluntarily authorize my child to participate in the camp’s soccer instruction, drills, games, and related supervised activities. LIMITED RELEASE OF INHERENT-RISK CLAIMS To the extent permitted by Florida law, on behalf of my child and myself, I waive and release claims against Southwest Florida Surge Athletics LLC and its owners, affiliates, employees, and agents for personal injury, including death, or property damage resulting from inherent risks of these activities. This release is limited to inherent risks as described in section 744.301, Florida Statutes. It does not release claims arising from the activity provider’s negligence or other conduct to the extent those claims cannot lawfully be waived. HEALTH INFORMATION AND SAFETY I will provide accurate information about my child’s allergies, medical conditions, medications, limitations, and accommodations relevant to safe participation. I confirm that my child can participate safely, subject to any limitations I have disclosed and any necessary medical clearance. My child must follow staff instructions, use required protective equipment, and immediately report injuries or illness. Staff may stop or restrict participation for safety reasons.
EMERGENCY ASSISTANCE If my child becomes injured or ill, I authorize camp staff to provide reasonable first aid within their training and to contact emergency medical services. Staff will attempt to contact me or the emergency contact listed in the registration. I consent to emergency evaluation and treatment by licensed medical professionals when permitted by law. I understand that I am responsible for medical expenses associated with my child’s care, subject to applicable insurance coverage.
PICKUP AUTHORIZATION I will arrange timely pickup by a parent, guardian, or another person I have authorized. I will notify camp staff of changes to pickup arrangements and any applicable custody restrictions
. NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF SOUTHWEST FLORIDA SURGE ATHLETICS LLC USES REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY WHICH CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD’S RIGHT AND YOUR RIGHT TO RECOVER FROM SOUTHWEST FLORIDA SURGE ATHLETICS LLC IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND SOUTHWEST FLORIDA SURGE ATHLETICS LLC HAS THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.