Recognizing the possibility of physical injury associated with soccer and in consideration for the individual organization accepting the registrant for its programs and activities, I hereby release, discharge, and/or indemnify the Dutch Connections FC Academy, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.
As the Parent of Legal Guardian of the above named player or Player over 18, I hereby give consent for emergency medical care provided by an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.
I understand that any personal information collected on Dutch Connections FC (DCFC) forms is collected and intended to be used to enable the DCFC Academy to deliver its programs to its members. My personal information will be kept secure and will not be shared with anyone other than those individuals charged with administering the DCFC Academy programs or in cases where disclosure is required to participate in a sanctioned event.
I give my full permission to the DCFC Academy to use my (and that of the registrant) name, likeness, photographs, videotapes or other recordings of me (and the registrant) that are made during my participation in DCFC Academy events, for promotional purposes. (You may request an exclusion by sending an email to email@example.com quoting the player name and reason for exclusion.)