Home‎ > ‎

Waiver and Release of Liability

(To be signed by participants 18 years of age and older)

This is a binding legal agreement. As a participant in the programs, activities and events of the
Belmont Minor Soccer Association, the undersigned acknowledges and agrees to the following

1. Disclaimer

The Belmont Minor Soccer Association, their directors, officers, members, employees, coaches,
volunteers, officials, participants, clubs, agents, sponsors, owners/operators of facilities, and
representatives (the "Organization") are not responsible for any injury, damage or loss of any
kind suffered by a participant during, or as a result of, any program, activity or event, caused in
any manner whatsoever including, but not limited to, the negligence of the Organization.

2. Description of Risks:

In consideration of my participation in such programs, activities and events, I hereby
acknowledge that I am aware of the risks and hazards associated with or resulted to soccer.
The risks and hazards of soccer include, but are not limited to the following:

• Injuries from executing strenuous and demanding physical techniques in soccer;
• Injuries from grass, turf and other surfaces including bacterial infections and rashes;
• Injuries resulting from falls to the ground due to an even or a regular terrain or services;
• Injuries resulting from failure to properly use any piece of equipment or from the
mechanical failure of any piece of equipment;
• Injuries from extreme weather conditions which may result in heart stroke, sunstroke or
• Injuries from contact, running, colliding or being struck by other participants, spectators,
equipment or vehicles;
• Injuries resulting from vigorous physical exertion and strenuous cardiovascular workouts;
• Injuries from exerting and stretching various muscle groups; and
• Travel to and from competitive events and associated non-competitive events which are
an integral part of the organization's activities.

4. Release of Liability:

In consideration of the Organization allowing me to participate, I agree:

a.) To assume all risk arising out of, associated with or related to my participation;
b.) To be solely responsible for any injury, loss or damage that I might sustain while
participating; and
c.) To release the Organization from liability for any and all claims, demands, actions and
costs that might arise out of my participating, even though such risks, injuries, loss, 
damage, claims, demands, actions or costs may have been caused by the negligence of
the Organization.

5. Acknowledgement

I knowledge that I have read this agreement, that I have executed this agreement voluntarily.
By signing this Waiver and Release, I understand that I, on behalf of myself and the participant,
I am giving up certain legal rights, including the right to sue.

Child’s Name:_______________________________________________________

Parent/Guardian Printed Name: _________________________________________

Signature: __________________________________________________________

Date:(DD/MM/YYYY): _________________________________________________
Willem Verhulst,
Apr 5, 2021, 2:49 PM