INDOOR SOCCER LEAGUE ROSTER/WAIVER FORM  INDOOR SOCCER LEAGUE ROSTER/WAIVER FORM 
  
Please read this form carefully before you sign.
In consideration of the person/player named below being permitted on the 
premises of Triple Crown Sports and accepted to participate in 
soccer/volleyball/basketball/baseball or any organized activity by Triple Crown 
Sports management and staff, the undersigned, having the complete right to 
execute this release on behalf of the player named below, does hereby understand 
and agree as follows: I agree that the player named below, of his/her own free 
will and choice, has voluntarily elected to participate in the aforesaid 
activities and that no one has forced him/her to join or participate. I agree 
that the undersigned player will abide by all the rules and regulations of 
Triple Crown Sports in effect from time to time. I further understand that the 
aforesaid activities are potentially dangerous sporting activities and that 
injury, damage and death are possible outcomes of participation in these 
activities at Triple Crown Sports. Therefore, in consideration of the acceptance 
of players participation in these activities, I, for myself and on behalf of my 
child/ward, our heirs, executors, administrators and personal representative, do 
hereby discharge, waive and release Triple Crown Sports, their partners, 
sponsors, coaches, instructors, agents, employees and owners from any claims, 
responsibility or liability due to injury, damage or death arising out of or in 
connection with said player’s participation in said activities and agree to hold 
Triple Crown Sports harmless from any and all such claims. I further hereby 
assume, for myself and behalf of my child/ward all risk for injury or loss to 
which he/she or I may be exposed while on the premises of Triple Crown Sports. I 
further waive the right to sue Triple Crown Sports, their partners, sponsors, 
coaches, instructors, agents, employees, and owners as a result of any such 
claim in any court of law or political jurisdiction. By signing the below 
waiver, I hereby grant to Triple Crown Sports LLC (hereafter referred to as 
Company) permission and consent to photograph (by video photography or still 
photography and with or without sound track) my image, voice or name for use in 
media products as they see fit, and to use such images and recorded sounds in 
the exhibition, advertising, editorial use and publicizing thereof as Company, 
its assigns, successors and licenses may elect. I understand that I am not 
entitled to compensation for use of my image or voice.
I acknowledge that I have read and fully understand this release and waiver; 
that I have the right to sign it either as a player of 18 years of age or older 
or as a guardian or parent for a player who is a minor not yet 18 years of age.
 
Team Name:__________________________________            Session/Year: Winter 
Session 2010
                                                                                 
                                                      
Age Division (Circle One):   U6         U8         U10         U12         U14   
      HS-B         HS-G         Adult
 
       First/Last NameMailing AddressZip CodePhone #Alt. Phone #DOBEmail 
      addressParent/Guardian Signature
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