ODP Event Releases 2017/18

The following releases are required by all players before participating in any US Youth Soccer ODP events.

You will be required to upload/attach a copy of both the FRONT and BACK of your insurance card.
























Please provide a minimum of one Parent/Legal Guardian.















Please provide a minimum of one emergency contact.



























List Name of Individual






Please upload copies of both the FRONT and BACK of your insurance card.



Recognizing the possibility of injury or illness, and in consideration for US Youth Soccer and members of US Youth Soccer accepting my son/daughter as a player in the soccer programs and activities of US Youth Soccer and its members (the "Programs"), I consent to my son/daughter participating in the Programs. Further, I hereby release, discharge, and otherwise indemnify US Youth Soccer, its member organizations and sponsors, their employees, associated personnel, and volunteers, including the owner of fields and facilities utilized for the Programs, against any claim by or on behalf of my player son/daughter as a result of my son's/daughter’s participation in the Programs and/or being transported to or from the Programs. I hereby authorize the transportation of my son/daughter to or from the Programs.

My player son/daughter has received a physical examination by a licensed medical doctor and has been found physically capable of participating in the sport of soccer. I have provided written notice, which is submitted in conjunction with this release and attached hereto, setting forth any specific issue, condition, or ailment, in addition to what is specified above, that my child has or that may impact my child's participation in the Programs. I give my consent to have an athletic trainer and/or licensed medical doctor or dentist provide my son/daughter with medical assistance and/or treatment and agree to be financially responsible for the reasonable cost of any such assistance and/or treatment.



By entering my name below, I represent that I am a Parent/Legal Guardian of the minor named above and I agree that the waiver and agreement to participate contained therein binds me and the minor to all of its terms.













By entering my name below, I agree that the waiver(s) and agreement(s) to participate contained therein binds me to all of its terms


By entering my name below, I represent that I am a Parent/Legal Guardian of the minor named above and I agree that the waiver(s) and agreem




Of Person Completing Online Form






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