This Waiver and Release of Liability, Assumption of Risk, and Medical Treatment Authorization ("Waiver") is entered into by the undersigned parent or legal guardian in connection with the registration for and participation of each child you name in the signature section below (individually and collectively, the "Participant") in any camp, clinic, training session, class, event, or other activity offered by Free Kicks Academy LLC, its owners, officers, directors, employees, coaches, agents, contractors, volunteers, sponsors, advertisers, and affiliates, and, if applicable, the owners and lessors of any facility or premises used for the Programs (collectively, "Free Kicks Academy"). One signature below covers every child you name for that signature.
1. Assumption of Risk. Participation in soccer and related training activities carries inherent risks that cannot be eliminated, regardless of the care taken to avoid injury, including cuts, sprains, strains, and bruises; fractures, dislocations, and other joint or back injuries; eye injuries; heat-related illness; concussions and other head or neurological injuries; and, in rare cases, catastrophic injury, paralysis, or death. These risks may result from the athletic activity itself, the use of training equipment, the condition of the field or facility, the actions of coaches, other players, or third parties, or the limited availability of on-site emergency medical care.
I ACKNOWLEDGE HAVING READ AND UNDERSTOOD THIS PARAGRAPH, AND, ON BEHALF OF MYSELF AND EACH CHILD I NAME BELOW, I VOLUNTARILY ASSUME ALL OF THE RISKS DESCRIBED ABOVE, KNOWN OR UNKNOWN, AND UNDERSTAND THAT THIS ASSUMPTION OF RISK APPLIES TO ALL PROGRAMS, INCLUDING PRACTICES, CAMPS, CLINICS, SCRIMMAGES, GAMES, TOURNAMENTS, AND ANY RELATED TRAVEL.
2. Compliance with Program Rules. I, and each child I name below, agree to follow all posted and customary rules, instructions, and safety guidelines for the Programs. If I or my child observe an unusual or significant hazard or safety concern at any time, I agree to immediately stop participating in the affected activity and bring it to the attention of a Free Kicks Academy coach or staff member.
3. Release of Liability and Covenant Not to Sue. In consideration of being permitted to participate in the Programs, I, on behalf of myself and each child I name below, and our respective heirs, assigns, and personal representatives, hereby release, waive, discharge, and covenant not to sue Free Kicks Academy from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, illness, or injury, including death, that may be sustained while participating in the Programs, while on the premises where the Programs are conducted, or while traveling to or from the Programs, INCLUDING CLAIMS BASED ON THE ORDINARY NEGLIGENCE OF FREE KICKS ACADEMY.
This release does not apply to, and Free Kicks Academy does not seek to be released from, liability for gross negligence, willful misconduct, or intentional acts.
Texas law does not permit a parent or guardian to waive a minor child's own personal-injury claim. Accordingly, this release, as it pertains to each minor Participant, applies to the claims of the signing parent/guardian in their own individual capacity, including any derivative claims. See Section 4 below for the related indemnification obligation a parent/guardian personally undertakes.
4. Indemnification and Hold Harmless. I, on behalf of myself and, where applicable, as parent/guardian of each child I name below, agree to indemnify and hold harmless Free Kicks Academy from any and all claims, judgments, costs, and expenses (including reasonable attorneys' fees) that Free Kicks Academy may incur as a result of a child's involvement in the Programs, including any claim brought by or on behalf of a minor Participant that is not barred by the release in Section 3, except to the extent such claim arises from the gross negligence or willful misconduct of Free Kicks Academy.
5. Medical Treatment Authorization. I authorize Free Kicks Academy staff to obtain emergency medical care for any child I name below if, in the reasonable judgment of Free Kicks Academy personnel, such care is needed and a parent/guardian cannot be reached after a reasonable attempt to do so. This authorization includes consent to any x-ray, evaluation, anesthetic, medication, or treatment ordered by a licensed physician, and to transportation to a medical facility. I am financially responsible for the cost of any medical care received, and Free Kicks Academy and its staff are not responsible for the medical decisions made by any treating professional. I confirm that each child I name below is, to the best of my knowledge, physically able to participate in soccer activities.
6. No Accident or Health Insurance Provided. FREE KICKS ACADEMY DOES NOT CARRY, AND IS NOT RESPONSIBLE FOR PROVIDING, ACCIDENT, HEALTH, OR MEDICAL INSURANCE COVERING ANY PARTICIPANT. I CONFIRM THAT EACH CHILD I NAME BELOW IS COVERED BY VALID HEALTH INSURANCE FOR THE DURATION OF PARTICIPATION IN THE PROGRAMS, AND I ACCEPT SOLE FINANCIAL RESPONSIBILITY FOR ANY MEDICAL EXPENSES NOT COVERED BY THAT INSURANCE.
7. Concussion Safety Acknowledgment. Free Kicks Academy follows age-appropriate heading guidelines consistent with U.S. Soccer / US Club Soccer player-safety standards, including no intentional heading for players age 11 and under and limited, supervised heading practice only for players age 12–13. I understand and agree that:
- A child suspected of having a concussion will be removed from play immediately and may not return the same day.
- A child suspected of having a concussion may not return to any Free Kicks Academy activity without written clearance from a licensed healthcare provider.
- I am responsible for reporting to Free Kicks Academy staff any known or suspected concussion or head injury, whether it occurs during a Program or elsewhere.
What is a concussion? A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head, or by a hit to the body that causes the head and brain to move quickly back and forth. I understand that this fast movement can cause the brain to bounce or twist inside the skull, and that even with a helmet or other equipment, there is no way to fully eliminate the risk of head injury.
Signs a coach or parent may observe: appears dazed or stunned; is confused about an assignment, position, or the game, score, or opponent; moves clumsily; answers questions slowly; loses consciousness, even briefly; shows a change in mood, behavior, or personality; or cannot recall events from before or after a hit or fall.
Symptoms a child or teen may report: headache or "pressure" in the head; nausea or vomiting; balance problems, dizziness, or blurry or double vision; sensitivity to light or noise; feeling sluggish, hazy, foggy, or groggy; confusion, or trouble concentrating or remembering; or simply not "feeling right" or "feeling down."
Seek emergency care right away (call 911 or go to the nearest emergency department) if, after a bump, blow, or jolt to the head or body, a child shows any of the following: one pupil larger than the other; drowsiness or inability to wake up; a headache that gets worse and does not go away; slurred speech, weakness, numbness, or decreased coordination; repeated vomiting or nausea, convulsions, or seizures; increasing confusion, restlessness, or agitation; or any loss of consciousness, even briefly.
A child or teen who continues to play with concussion symptoms, or who returns to play before fully healing, has a greater chance of a repeat concussion, which can be serious and, in rare cases, fatal. I understand that only a licensed healthcare provider — not a coach, staff member, or parent — should assess whether a child is ready to return to play. Additional information on recognizing and responding to concussions is available from the CDC HEADS UP initiative at cdc.gov/heads-up.
8. Communicable Disease Risk Acknowledgment. I understand that participating in group athletic activity carries an inherent risk of exposure to communicable illnesses, including but not limited to influenza, RSV, and COVID-19 and its variants. I voluntarily assume this risk on behalf of myself and each child I name below and agree that the release in Section 3 and the indemnification in Section 4 extend to any claim arising from exposure to a communicable disease in connection with the Programs, to the same extent as any other covered claim.
9. Use of Personal and Medical Information. I authorize Free Kicks Academy to collect and use the information provided in this Waiver for program administration, player safety, and emergency response, including sharing relevant medical information with coaches, camp staff, and emergency medical personnel when necessary for a child's care. Free Kicks Academy will not sell this information and will not share it with third parties except as described above, as needed to respond to a medical emergency, or as required by law.
10. Photo, Video, and Media Release. I grant Free Kicks Academy permission to photograph or record each child I name below during Programs and to use those images or recordings, without compensation, in Free Kicks Academy's marketing and promotional materials, including its website and social media. This consent may be revoked at any time by written notice to Free Kicks Academy; revocation will not apply to material already published before Free Kicks Academy receives the notice.
11. Governing Law and Severability. This Waiver is governed by the laws of the State of Texas, without regard to its conflict-of-laws principles. If any provision of this Waiver is held invalid or unenforceable, the remaining provisions will remain in full force and effect.
I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY IN ITS ENTIRETY. I UNDERSTAND THAT BY SIGNING BELOW, I AM GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE FREE KICKS ACADEMY FOR ORDINARY NEGLIGENCE. I SIGN THIS WAIVER FREELY AND VOLUNTARILY, WITHOUT ANY INDUCEMENT, ON BEHALF OF MYSELF AND EACH CHILD I NAME BELOW.
By entering your name and contact information above, typing each child's full legal name below, and checking the agreement box, you are electronically signing this Waiver on behalf of that child.
This is a legal document that affects your rights. Free Kicks Academy LLC recommends that you read it carefully and, if you have questions, consult an attorney licensed in Texas before signing. This form is provided for general use and has not been reviewed by an attorney on your behalf.
Enter your name and email or phone number in the fields at the top of this form before signing below.
