Player Registration

2020 MO Western Girls College ID Clinic - August

Option:  

Required  Price: $145.00
Description: Camp
 = Required Field

 Player Information

 
 
 
 
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  AGE GROUP ('20-'21) 
 
                    
 
 
 
 School ('20-'21): 
 Grade ('20-'21): 
 Player Type: 
 GPA: 
 ACT: 
 SAT: 
 Grad. Date: 
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 Player Email: 

 Soccer References

       
       
 Emergency Contact 
 Emergency # 
Comments 


 Approvals

I approve of my daughter's attendance at the Missouri Western State University ID Camp and certify that she is in good health and able to participate in program activities. I hereby authorize the directors of the Missouri Western State University and their employees and/or volunteers to act for me according to their best judgment in any emergency requiring medical attention, including treatment by a physician. I hereby release Missouri Western State University/GSI Sports and it's staff from responsibility or liability for injury while participating in the camp.

Assumption of the Risk and Waiver of Liability Relating to Coronavirus / COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health

Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. GSI Sports has put in place preventative measures to reduce the spread of COVID-19; however, GSI Sports cannot guarantee that you will not become infected with COVID-19.

Further, participation could increase your risk of contracting COVID-19.

READ CAREFULLY BEFORE SIGNING

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death.

I understand that the risk of becoming exposed to or infected by COVID-19 at GSI Sports events may result from the actions, omissions, or negligence of myself and others, including, but not limited to, GSI Sports employees, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation at GSI Sports events. I hereby release covenant not to sue, discharge, and hold harmless GSI Sports, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of GSI Sports, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation at GSI Sports events.

I represent that I have adequate insurance to cover any injury or illness I may suffer or cause while participating in this activity or else I agree to bear the costs of such injury or illness myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity or else I am willing to assume all risks and costs that may be created directly or indirectly.

In the event that I file a lawsuit, I agree to do so in the state where GSI Sports is located, and I further agree that the substantive law of that state shall apply. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

By signing this document, I agree that if I am exposed or infected by COVID-19 during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.

If I have signed a separate waiver of liability connected to my participation at GSI Sports, I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver.

I agree that I will practice using the safety protocols put in place by GSI Sports

 

    

 CONTACT INFORMATION

GUARDIAN #1

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 
GUARDIAN #2 (optional)

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 

 Refund Policy

Please note;

COVID-19 - GSI will adhere to all regulations/rules/guidelines suggested by US Soccer, CDC when facilitating a camp. Parents will be required to sign waivers.

Refund Policy - Due to the COVID-19 concerns a full refund will be available up to the day of camp. We appreciate your patience and support. We are looking forward to getting out there with the players

 Contact Info