I authorize my child’s photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising), television, video, or radio coverage of KICKSTART, without compensation.

I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue, the KickStart Soccer Program, Hindman First Baptist Church, the facility where the KickStart Soccer Program is operating, their associated directors, administrators, officers, managers, employees, coaches, trainers, volunteers, sponsors and advertisers, and other agents, estates or executors, from any and all liability incurred in the conduct of, and my child’s participation in, KICKSTART.*

I understand that the previous checkbox includes owners, lessors, and lessees of premises, municipalities, government agencies, successors, heirs, and assigns. In the same way, I also release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue, any and all of the aforementioned for any damage done to my personal property where the KickStart Soccer Program is operating.*

I understand that KICKSTART does not provide primary personal injury insurance that covers my participation. Therefore, I should have a current, active, personal injury insurance policy in force, which covers my child’s participation. *

Under any condition, I understand that my primary insurance policy is responsible for any medical expenses arising from my child’s participation, both in practices and games and while travelling to and from these events. *

I have the right and responsibility to inspect the equipment and facilities prior to events and, if I believe that anything may be unsafe, I will advise the coach or supervisor of the condition and may refuse to allow my child to participate. Participation assumes consent.*

I will ensure that my child will not compromise themselves in such a way as to do harm to the league, the facilities and/or property where the KickStart Soccer program operates, or any supporting businesses and organizations, knowing that players may be dismissed from participation, for violent conduct or unsportsmanlike behavior on or off the field. I agree to pay for any and all damages to any property or indemnities caused by my child’s willful, negligent, or otherwise harmful behavior.*

I understand that soccer is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards associated with my child’s participation in the sport. I attest that they are in proper physical condition to participate in soccer practices and games and have no illness, disease or existing injury or physical defect that would be aggravated by their participation. I will inform my child’s coach if this status changes.*

I further acknowledge that this risk may involve loss or damage to myself, my child, or my property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. My child will wear shin guards, properly fitted and appropriate shoes.*

I have completely read this document and fully understand its contents. I acknowledge that I have given up substantial rights by accepting this document and that I do so voluntarily. My signature attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns.*