2025 ICEBREAKER Futsal Tournament - Player Waiver

PLAYER INFORMATION
I certify that all information about the player named in this waiver is correct, including full name, date of birth, and gender.

MEDICAL INFORMATION
I certify that my player HAS active medical insurance and is currently healthy and cleared to play contact sports. I am aware that my player may come into contact with possible illnesses and/or allergens during this activity and assume full responsibility for any illnesses or injuries that may result from participation in this event. If my child has a medical condition (i.e., asthma), my child's coach is aware of any medical conditions that my child has and we will provide the necessary medications/supplies in the event they are necessary.

GENERAL RELEASE & WAIVER
By signing this General Release & Waiver, you are assuming certain risks and waiving certain rights, including a right to sue. Please read it carefully before signing it. EVERYONE must sign this document before playing in the WBSC & CU-LH Futsal Tournament. As a condition of using the Commonwealth University of PA (Lock Haven) facilities, I agree to 1) adhere to applicable rules, regulations and policies; 2) exercise reasonable care and good judgment in using the facilities; and 3) observe the prescribed rules and hours of use. I acknowledge that activities taking place during a soccer tournament have inherent risk of injury, including, but not limited to, those related to contact with the field, equipment surrounding the field, contact with other individuals on the field, contact with equipment on the field, including the nets and the equipment used by those on the fields. I further assume all risks, including injury and property loss as a result of my participation in this event, even though such risks may have been caused by the negligence of the tournament, and do release all parties (West Branch Soccer Club, Commonwealth University of PA, and Tournament Organizers) and its agents and employees, on behalf of myself, my executors and assigns, from any claim or cause of action arising out of or related to my participation in the WBSC & CU-LH Futsal Tournament. I agree that WBSC & CU-LH are solely the beneficiaries of this event and are in no way liable or responsible for any injuries.

As a condition of playing in this tournament, we must have a waiver on file for EVERY PLAYER. If a team is found to have players who have NOT COMPLETED A WAIVER, their team will be disqualified from this event.

REMINDER: Please type the PLAYER'S NAME and DATE OF BIRTH... NOT THE PARENT.