Canada First Academy for Soccer Excellence

PARTICIPATION/TRY-OUT WAIVER FORM FOR THOSE UNDER 18 YRS

By signing this document you will waive certain legal rights, PLEASE READ CAREFULLY.

Participant: _________________________________ Birth Date (D/M/Y): _______________

FOREMOST, Canada First Academy and officials have done and will do all they can reasonably do to ensure a
safe practice and playing environment!

IN CONSIDERATION of my child/ward’s acceptance into Canada First Academy (“CFA”) and the ability of my child/ward
to participate as part of CFA programs, activities and events (including any before and after-event activities):

I, on behalf of myself and the other Releasees (as defined below) ASSURE TO YOU THAT:
I am the parent/guardian of the above named participant having full legal responsibility for decisions regarding the above-
named participant.
There are no reasons known, or which ought to reasonably be known or suspected, that my child/ward is not sufficient
physically or mentally to participate in the training, competition, events and/or activities of CFA.
I hereby acknowledge that I am aware of the risks and hazards associated with or related to soccer. The risks and
hazards include, but are not limited to injuries from:
executing strenuous and demanding physical techniques in soccer;
dryland training including weights, running and massage;
grass, turf and other surfaces including bacterial infections and rashes;
falls to the ground due to uneven or irregular terrain or surfaces;
collisions with walls and soccer equipment;
failure to properly use any piece of equipment or from mechanical failure of any piece of equipment;
extreme weather conditions which may result in heatstroke, sunstroke or hypothermia;
contact, colliding or being struck by other participants, spectators, equipment or vehicles;
vigorous physical exertion and strenuous cardiovascular workouts;
exerting and stretching various muscle groups; and
travel to and from competitive events and non-competitive events which are a part of CFA’s activities.

Furthermore, I am aware that my child/ward may:

sustain injuries that can be severe, cause spinal cord injuries and even be fatal;
experience anxiety while challenging herself/himself during the activities, events and programs;
come into close contact with other participants, including the possibility of accidental and unexpected contact;
risk of injury is reduced if he/she follows all rules established for participation; and
risk of injury increases as he/she become fatigued.

Canada First Academy for Soccer Excellence, 628 Milverton Blvd, ON, M4C 1X7, (647) 973 9555,
rene.kwol@canadafirstacademy.com
I UNDERSTAND AND AGREE, on behalf of myself, my children, my wards, my heirs, assigns, personal representatives
and next of kin (collectively, the “Releasees”) that:
I am registering my child/ward willingly to participate voluntarily in these activities, events and programs.
I agree that there are risks, as listed above, and my child/ward will be exposed to these risks and hazards.
Should I become aware of any reason for my child/ward to not be physically and/or mentally fit to participate in training,
competitions, events and/or activities of CFA, I will immediately notify the President of CFA, in writing, of such and shall
immediately withdraw my child/ward for any training, competition, events and/or activities.
I agree to accept all these risks and hazards and be responsible for any injury or other loss, which my minor child/ward
might receive while participating in these events, activities and programs.
I, on behalf of myself and my child/ward grant permission to CFA to collect and utilize the personal information of
child/ward provided above to administer and conduct the events, activities, training, competition (the “ Program”) and to
collect and use the child/ward’s name, voice, statements, photograph, image, likeness, actions at the Program and/or
child/ward’s biographical data in any live or recorded form (including, but not limited to, any form of video display or other
transmission or reproduction), in whole or in part, for purposes of promoting CFA and/or any of the Programs associated
with the CFA, in perpetuity worldwide on standard and non-standard television, video, print, electronic and on-line media
(including, without limitation, the Internet), and in any other means of distribution, publication or exhibition, whether now
known or hereinafter created without any additional consideration in connection with the Program, future programs, and
the marketing, advertising and promotion thereof. In addition to the foregoing, I hereby give permission to CFA and their
respective officers, directors, governors, owners, and affiliates to collect and use child/ward’s contact information (being
my name, address, telephone number and e-mail address) to communicate with you and/or the child/ward about
upcoming Academy events, ticket and merchandise offers and special promotions, and share child/ward’s contact
information with CFA corporate partners to receive exclusive offers and special opportunities from such
partners/suppliers/advertisers. If at any time child/ward would like to withdraw his/her consent to any future
communication with CFA, the child/ward may do so by sending an e-mail to rene.kwol@canadafirstacademy.com
indicating child/ward's desire to withdraw from any future communication from CFA.
I, on behalf of myself and the other Releasees, RELEASE the Organizers (as “Organizer” is defined below) of
responsibility from any claims, demands, actions, expenses, costs, and causes of action, whether arising in law or equity,
in respect of death, injury, loss or damage to person or property, HOWSOEVER CAUSED, arising or to arise by reason of
my child/ward’s or any of the Releasees’ participation with CFA (whether as a spectator, participant, competitor, volunteer
or otherwise) whether prior to, during or subsequent any events, activities, training and/or competition put on by, or in any
way associated with CFA or any of its Partners, AND NOTWITHSTANDING that same may have been contributed to or
occasioned by the negligence of any of the Organizers. I FURTHER HEREBY UNDERTAKE AND HOLD AND SAVE
HARMLESS AND AGREE TO INDEMNIFY all of the Organizers from and against any and all liability incurred by all or
any of them as a result of, or in any way connected with, my child/ward or any of the Releasees’ participation with CFA
(as an athlete, spectator, participant, competitor, volunteer or otherwise). I understand “ Organizers” to mean: The
Canada First Academy, its directors, officers, members, employees, coaches, volunteers, officials, participants, clubs,
agents, sponsors, owners/operators of facilities, and representatives.

Accident Insurance
Executing this agreement will not preclude you from accident insurance coverage, subject to the terms and conditions of
CFA’s and/or School Board insurance policy.

I ACKNOWLEDGE MAKING THIS AGREEMENT

I have read and understood the terms and conditions of this agreement, and by signing it voluntarily, I am agreeing to
abide by these terms.

_________________________________ ___________________________ ________________

Printed Name of Parent or Guardian Signature of Parent or Guardian Date

______________________________________________________ ___________________________
Address Email

Phone _____________________

Canada First Academy for Soccer Excellence, 628 Milverton Blvd, ON, M4C 1X7, (647) 973 9555,
rene.kwol@canadafirstacademy.com