I understand and acknowledge that _________________________’s participation in the athletic program and related events and activities, including training, games and tournaments, offered by and in connection with PA WEST SOCCER ASSOCIATION/JAGUARS UNITED SOCCER ASSOCIATION may pose dangers and risks of possible exposure to and illness from infectious diseases, including but not limited to influenza and COVID-19. I understand that while particular rules and procedures may be in play in an attempt to reduce risk, the risk of serious illness or death exists. I understand that PA WEST SOCCER ASSOCIATION/JAGUARS UNITED SOCCER ASSOCIATION assumes no responsibility for any and all illness, disability, death or loss of damage to person or property in connection with my participation.
I hereby waive, release, and discharge PA WEST SOCCER ASSOCIATION/JAGUARS UNITED SOCCER ASSOCIATION from any and all liabilities or claims, financial or otherwise, made as a result of participation in the athletic program and related events and activities.
We agree to notify the JAGUARS UNITED SOCCER ASSOCIATION within 24 hours if the participant or member of the participant’s household has had (1) confirmed exposure to COVID 19, or (2) is experiencing any of the following symptoms: documented fever above 100.4, persistent dry cough, shortness of breath, experiencing chills, sore throat, experienced loss of taste/smell, trouble breathing, chest pain.
We have read and agree to follow the Jaguars United Soccer Association COVID 19 protocols.
Participant Name (printed) _____________________________________
Parent/ Guardian Signature ______________________________________ Date ______________
Participant Signature, if age 18 or over _______________________________ Date ______________