Have more than one player on the team? Submit this form again for each one — every player needs their own waiver.
Assumption of risk. Futsal and indoor soccer are physical contact sports carrying inherent risk of injury, including sprains, fractures, concussion and other head injury, dental injury, heat illness, permanent disability, and death. These risks cannot be eliminated regardless of the care taken. I knowingly and voluntarily assume all such risks on behalf of the player named above.
Release and waiver. In consideration of participation, I release, waive, and discharge Sporting Blue Valley Soccer Club, Top Flight Futsal Academy, the Blue Valley School District, and their directors, officers, employees, coaches, volunteers, referees, agents, and facility owners from all claims, demands, and causes of action arising from any loss, damage, or injury sustained in connection with this event, including any caused by ordinary negligence of the parties released. I agree to indemnify and hold harmless the parties released above from any loss, liability, damage, or cost, including attorney's fees, arising out of the player's participation.
Medical authorization. I authorize event staff to obtain or administer emergency first aid and to secure emergency medical treatment if I cannot be reached, and I accept financial responsibility for that treatment. I confirm the player is physically fit to participate. No athletic trainer is on site. A first aid kit is maintained at the scorer's table and 911 will be called for any emergency. Any player suspected of a head injury is removed from play for the remainder of the event and may not return without written clearance from a licensed medical provider. This decision rests with SBV staff on site and is not appealable.
Age accuracy. I certify the player's date of birth above is accurate. Divisions are set by each team's oldest player, and a team found with a player above its declared division forfeits every game played.
Code of conduct. Every referee at this event is a student-athlete volunteer. All referee decisions are final. I will not address a referee at any time — I will go to the scorer's table and ask for SBV staff. Sporting Blue Valley operates a zero-tolerance policy toward harassment of officials, and I understand I may be asked to leave the facility for violating it.
Facility and participation rules. I agree that my player will wear flat, non-marking indoor shoes on the gym floor — no cleats and no turf shoes — and I understand this is checked at the door and my player cannot play without them. I agree that we will enter and exit through Door #9 only, arrive 30 minutes before our first game, keep food and drink other than water outside the gym, and wait outside the building until our wave is called.
Media consent. I grant Sporting Blue Valley and Top Flight Futsal Academy permission to photograph and record my player at this event and to use those images and recordings for promotional purposes, without compensation.
