CONSENT & COVID-19 FORMS

CODE OF CONDUCT

I will not engage in unsportsmanlike conduct with any coach, parent, player, participant, official, or any other attendee and will treat them with respect at all times. I will not engage in any behavior that would endanger the health, safety, or well-being of any coach, parent, player, participant, official, or any other attendee. I will not use profanity or any other offensive or aggressive language even if it is not directed at a particular person.

 

LIABILITY RELEASE

I the undersigned parent/guardian do hereby give permission to any emergency x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care, which is deemed advisable by and is to be rendered under the general or special supervision of, any physician and surgeon licensed under the provisions of the Medical Practice Act.

 

It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required. It is given to provide authority and power on the part of Surf and Sand Field Hockey to give specific consent to any and all such diagnoses, treatment or hospital care which the aforementioned physician in the exercise of her best judgment may deem advisable; and neither said agent or any organization involved assumes any financial responsibility for exercising this action.

 

I realize that the sport of field hockey is potentially dangerous and involves considerable risk, including the possibility of broken bones, other internal injuries, or death. Therefore, I do hereby for myself, my heirs, executors, and administrators release Surf and Sand Field Hockey and the facilities where games/tournaments/ practices are conducted from all claims, demands, actions, liability or causes of actions resulting from any injury to my daughter, or my property or resulting of my, or my daughter’s death which may occur during participation in this sport.

 

Surf & Sand FHC

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

In consideration of being allowed to participate on behalf of Surf & Sand FHC athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1.       Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

2.       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 my participation; and,

3.       I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4.       I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Surf & Sand FHC their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Name: _____________________________________________________

Signature:__________________________________________________

Date signed: ________________________________________________

State Traveling From __________________________________________

Role_______________________________________________

Emergency Contact #______________________________________

          (Staff/College Coaches/Officials/Trainers/Club Coaches)

I ACKNOWLEDGE THAT I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY AND I FULLY UNDERSTAND ITS TERMS AND CONDITIONS.