MUST BE SUBMITTED FOR EACH PLAYER ON YOUR TEAM at REGISTRATION
This is a release form releasing the Essex United Soccer Club, its officers and Tournament Committee, as well as the Village of Essex Junction, Vermont, from all liability in the event of an injury during the June 22-23, 2019 Essex United Soccer Club Tournament & Shootout. One form per player, signed by a parent or guardian must be submitted for that player to be eligible to participate.
CONSENT FOR MEDICAL AID AND TREATMENT
By completing the form, you will be giving consent for your child to receive emergency medical treatment deemed advisable in the event of accident or illness during the Essex United Soccer Club Tournament & Shootout. You will assume responsibility for payment of any medical or dental treatment required, including ambulance fees.