DRFC Waiver of Liability and MEDIA RELEASE Form

This form must be completed for each player (participant) and must be signed by the player or if under the age of 18, a parent or legal guardian. No player will be allowed to participate in Delaware Rising Football Club (DRFC) practices, scrimmages, or games without this form, properly executed, and on file.

I, the undersigned, in consideration for my voluntary participation, do hereby willfully acknowledge that my signature below attests to my understanding and agreement that: 

I hereby acknowledge that I am familiar with the nature and risk of concussion and traumatic brain injury while participating in sports, including the risks associated with continuing to compete after a concussion or traumatic brain injury. 

Soccer is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards associated with my participation in the sport. I am in proper physical condition to participate in soccer practices, scrimmages and games and have no illness, disease or existing injury or physical defect that would be aggravated by my participation. I will inform my coach if this status changes. I further acknowledge that this risk may involve loss or damage to me or my property, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I will wear shin guards, properly fitted and appropriate shoes, and other protective equipment that may be needed or required, as provided by US soccer rules, to all events. 

Permission to administer emergency medical care: I consent for an emergency medical care provider to administer any emergency medical care deemed advisable to the welfare of the herein named player while the player is practicing for or participating in DRFC trainings, scrimmages, and/or games. Further, this authorization permits, if reasonable efforts to reach the emergency contact have been unsuccessful, physicians to hospitalize, secure appropriate consultation, to order injections, anesthesia (local, general, or both) or surgery for the herein named player. I hereby agree to pay for physicians’ and/or surgeons’ fees, hospital charges, and related expenses for such emergency medical care. I further give permission to the DRFC’s administration, coaches and/or team trainer to consult with the Authorized Medical Professional who executes care regarding a medical condition or injury to the herein named player member. 

The information on this form shall be treated as confidential by DRFC personnel. It may be used by the DRFC administration, coaches and team trainer to determine athletic eligibility to play or practice, to identify to the best of their ability in that moment possible medical conditions and injuries during play to discuss with you if available and determine if player should sit out, and to promote safety and injury prevention. In the event of an emergency, the information contained from a medical release form may be shared with emergency medical personnel. Information about an injury or medical condition will not be shared with the public or media without written consent of the player(s) and/or legal guardian(s) 

I hereby acknowledge that I am familiar with the requirements of NCAA and US Soccer concerning the eligibility of players to participate in DRFC practices, scrimmages, and/or games. 

My player status will be kept in good standing. I will not compromise myself in such a way as to do harm to DRFC, knowing that players may be dismissed from participation, with possible loss of payment or dues, for violent conduct or unsportsmanlike behavior on or off the field of play.   

I authorize my photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising and with sponsors), television, print, video, social media accounts or radio coverage of the club, league or tournament, without compensation. 

I have completely read this document and fully understand its contents. I acknowledge that I have signed this document voluntarily. My signature attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns. 

For those individuals under the age of eighteen (18) years (minor): 

As the parent and natural guardian or legal guardian of the participant, I hereby agree to the foregoing Waiver of Liability and Release for, and on behalf of, the participant (player/minor) named above. I hereby bind myself, the minor, and all other assigns to the terms of the Waiver of Liability and Release. I represent and certify that I have the legal capacity and the authority to act for, and on behalf of, the minor in the execution of this Waiver of Liability and Release. 

If you would like to opt out of signing this agreement electronically, you can download the following waiver via PDF. Once the file has been downloaded, review and sign the waiver agreement. Please send the completed document to delawarerising@gmail.com or bring it to the following tryout.