Revere Youth Soccer

www.revereyouthsoccer.com

REGISTER FORM


Player Information

I, the parent/guardian of the registrant, a n1inor, agree that I and the registrant will abide by the rules of the USYSA, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the USYSA accepting the registrant for its soccer programs And activities (the Progn.1ms}, I hereby release, discharge and/or other1,,vise indeinnify the USYSA, its affiliated organizations and sponsors, their e1nployees and associated personnel, including the owners of fields and facilities utilized for the pro grains, against any c\ai1n by or on behalf of the registrant as a result of lhe regislrant's participation in the programs and/or being transported to or from the sa1ne, which transportation! hereby authorize.

I, the parent/guardian of the registrant, a niinor, agree with the rules of USYSA, its affiliated organizations and sponsors, and in particular that the registrant will not be allowed to participate without rny providing full n1edical insurance coverage. Recognizing the possibility of a physical injury associated with soccer and in consideration for the lJSYSA accepting the registrant for its soccer programs and activities, I hereby provide n1edical coverage for the registrant and I shall maintain said policy and coverage till the registrant no longer participates in the programs sponsored by USYSA, and its affiliates. I hereby further agree that in the event the aforementioned policy is canceled. I shall imn1ediately notify USYSA and its affiliated organization and shall not pennit the registrant to participate in any USYSA Progra1n. As the parent or legal guardian of the above-na1ned player, l hereby give 1ny conse nt for e1nergency tnedica\ care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of n1y dependent.


Parent / Guardian's


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