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ANNAPOLIS SELECT FC ID CLINIC REGISTRATION 2023/2024

2015/16 Coed
2013 Boys
2013 Girls
2010/11 Boys

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)

Students entered below will be added to your family's account

Additional Information:

COVID-19 Liability Waiver

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The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID 19 is extremely contagious and is believed to spread mainly from person to person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. ANNAPOLIS SELECT FUTBOL CLUB has put in place preventative measures to reduce the spread of COVID 19; however, ANNAPOLIS SELECT FUTBOL CLUB cannot guarantee that you or your child(ren) will not become infected with COVID 19. Further, attending ANNAPOLIS SELECT FUTBOL CLUB events could increase your risk and your child(ren)'s risk of contracting COVID 19. By accepting this agreement, I acknowledge the contagious nature of COVID 19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID 19 by attending ANNAPOLIS SELECT FUTBOL CLUB events and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID 19 at a ANNAPOLIS SELECT FUTBOL CLUB event may result from the actions, omissions, or negligence of myself and others, including , but not limited to, ANNAPOLIS SELECT FUTBOL CLUB employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or my self (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)'s attendance at ANNAPOLIS SELECT FUTBOL CLUB or participation in ANNAPOLIS SELECT FUTBOL CLUB programming ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless ANNAPOLIS SELECT FUTBOL CLUB its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions , damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of ANNAPOLIS SELECT FUTBOL CLUB its employees, agents, and representatives, whether a COVID 19 infection occurs before, during, or after participation in any ANNAPOLIS SELECT FUTBOL CLUB program. I/we have read this assumption of the risk and waiver of liability relating to Coronavirus/ COVID 19, fully understand its terms, understand that I /we have given up substantial rights by agreeing to it and agree to it freely and voluntarily without any inducement.