Coloring Soccer Academy

COLORING REGISTRATION FORM (#18)

PERSONAL DATA: Participant

First Name

Last Name

Age

Date of Birth

Sex

Address

Uniform Size

FAMILY DATA:

Father's name

PHONE NUMBERS:

Phone

Ofi

Mobile

Mother's name

PHONE NUMBERS:

Phone

Ofi

Mobile

MEDICAL RECORD

Does the child have a physical disability or illness?

Is the child allergic to any medication and/or food?

Does the child take some type of medication?

Credit Card Authorization

Please use this form to authorize PV INTERNATIONAL SPORT KIDS to set up recurring credit card billing for services that we provide to you.

Name as it appears on the card:

Credit Card Number:

Expiration Date

Type of Credit Card:

Security Code

Phone Number of Cardholder

Billing Address of Cardholder

I hereby authorize PV INTERNATIONAL SPORT KIDS to charge the monthly amount the first 5 day of each month for the services provided and any applicable fees. I agree that this is a periodic charge that will be made according to my billing cycle. I must cancel my account within 5 days prior of recurring payment. I guarantee that I am the legal cardholder to use it at PV INTERNATIONAL SPORT KIDS

Signature of Card Holder

Date

WAIVER

I hereby release PV International Sports Kid and its officers, agents, employees and volunteers from all liability or claims that may be sustained by the participant named here, or a third party directly or indirectly in relation to, or arising from, of participation in the activity described in this document, whether caused, in whole or in part, by the negligence of, PV International Sport Kids or otherwise. I certify that the named participant is fully covered by medical insurance and that I am fully responsible for all costs incurred. I further certify that the previous participant is in good health and free of injury.

INITIALS:

As a parent / legal guardian I authorize PV International Sport Kids to use and display the images in which my minor appear in activities, competitions, etc. carried out within their facilities or in which they attend with the same, and the companies may published on social networks.

INITIALS:

The academy is in operation throughout the year except for the holidays, Spring Break and December days previously notified.

INITIALS:

Parent and representatives are not allowed to enter the court area except those who are authorized to integrate their representatives.

INITIALS:

Any questions or concerns should be communicated with the academy's management staff using the email address:

pv@pvinternational.net

INITIALS:

Legal guardian of

expressly agree and accept all the clauses and conditions established by the Organizing Committee, and based on them, I register my kid being understood that no claim subsequent to the signing of this agreement will be taken into consideration. Therefore, the complains related directly or indirectly to the content of some of the clauses described above, will not have support or validity.

Signature of the Representative

Date

Important note: Registration of the participant will not be effective if this form is not duly signed by the parent or representative. No exception

WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

In consideration of being allowed to participate on behalf of Coloring Dreams athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns and personal representatives, HEREBY RELEASE AND HOLD HARMLESS (insert name of sports organization) their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Name of participant:

Participant signature:

Date signed:

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

Name of parent/guardian:

Parent guardian/signature:

Date signed:

Note: This is a sample waiver form only. Final wording should be directed by the insured’s legal counsel but must observe the principles represented within the above. The signed waiver/release should be kept on file by the sports organization for at least 7 years and possibly longer if the player has contracted a serious illness.