Indoor Soccer Waiver

General Release of Liability:

I, the above listed name, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES being conducted at or sponsored by Centralia Community Church of God (hereafter the “Church”).

Activity at Centralia Community Church: indoor soccer/futsal 

 Date(s) of Activity: Every Tuesday Dec 3rd-Feb 25th

By checking this box, I understand the following: 

 I understand and agree that neither the Church, nor its trustees, representatives, employees, and agents may be held liable in any way for an occurrence in connection with the Activity which may result in injury, harm, or other damages to the undersigned, invited or not. Rather, I agree that the Organization/Overseer alone shall be responsible for any property damage, personal injury, or death that may occur during our use of the premises.

As part of the consideration for being allowed to use the C3 facility, building, and grounds as well as all appliances and fixtures in the activity, I release the Church, its trustees, employees, agents, or representatives from any claim for damages, injury or death which may occur while participating in the Activity. I further agree to save and hold harmless the Church, its trustees, employees, agents, or representatives from any claim arising out of or participation in any form or fashion in the Activity.

I acknowledge that I and all adult attendees who work with youth or children, have read and understand the Policy and agree at all times to abide by all terms and provisions of the Policy. In addition, neither the undersigned nor any adult (who works with youth or children) of any function held at C3 have been accused of, charged with, or participated in any activity in violation of law related to child abuse or neglect or any activity in violation of any term or provision of the Policy.

I further state that I am authorized to sign this agreement; that I understand the terms herein are contractual and not mere recital; and that I have signed this document of my own free act and volition. I further state and acknowledge that I have fully informed myself of the content of this affirmation and release by reading it before I signed it.

Do you agree to hold CCCOG harmless?
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Name of Player(s) / Nombre de los jugadores
Parent/Guardian Name / Nombre del padre/tutor
Parent/Guardian Phone Number / Número de teléfono
Parent/Guardian Email / Correo electrónico de padr
Age Group of Player(s) / Grupo de edad
select
Male or Female / Masculino o femenino
select
Verification
 

Required Fields
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