Individual Player Name:
Have you and/or any of the players traveled in the last 14 days prior to Augsut 20th, 2021?
Please note that it is your responsibility to let us know if your status on the Covid-19 questions have changed prior and during the event.
Team Contact Person:
Participation Fee: $12 per player
Participation includes possible exposure to and illness from infectious diseases including but not limited to influenza and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness does exist.
I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for the participation; and,
I willingly agree to comply with the terms for participation in regards protection against infectious diseases. If, however, I observe and any significant hazard during my presence or participation, bring such to the attention of an official.
By submitting this form, you hereby agree that Footy Promotions / Footy Force Futsal Academy, its members, coaches or officers, shall not be liable for any and all illness, disability or injury
or loss which my child or children may sustain while participating in activities of any kind, whether sponsored by or under the supervision of the Footy Promotions / Footy Force Futsal Academy.
We agree to indemnify and to hold harmless Footy Promotions / Footy Force Futsal Academy, its members, coaches, officers or designates from any kind of claim whatsoever.
The Participant, and the Parent(s) or Guardian(s), if the Participant is a minor child, grant authorization to Footy Promotions / Footy Force Futsal
to use photographs and video of the Participant for publicity purposes including Website, social media and print advertising content.
Please Initial Here To Sign on behalf of you and your team:
Please note that there are no refunds once the participant has started to play in the U23 Futsal Tournament
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