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PERSONAL INFORMATION

EDUCATION BACKGROUND

FUTURE EDUCATION

Fields of study or academic Majors of

SOCCER INFORMATION

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College Doorway Soccer Camp Enrollment Agreement
I have read & agree with the Terms & Conditions

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Payment Detail:

AGREEMENT TO PARTICIPATE

I- College Doorway Sports Medicine Medical and Liability Waiver

Activity: College Doorway ID Soccer Camp

This Waiver, Release and Medical Release is presented to me by College Doorway located at 1111 Brickell Ave. 11th floor, Miami, FL 33131 for my voluntary participation and I agree to abide by the following:

For myself, my estate, assigns and representatives, I hereby release, indemnify, hold harmless and forever discharge College Doorway and soccer camp host University, its trustees, officers, employees, and agents from any and all claims, liability, demands, lawsuits, and causes of action of any kind or nature, known or unknown, that I have or may have, arising from or related to my voluntary participation. I, for myself, my estate, assigns and representatives, hereby waive any and all claims of any kind or nature, known or unknown, for damages, injuries or losses to myself or my property arising from or related to my voluntary participation. Unless required by law or valid order of court, I shall not file, allow to be filed, consent to, or cooperate with any claim, cause of action, lawsuit, or demand of any kind or nature for injuries or losses to or by me arising from or related to my voluntary participation, and shall defend and indemnify college doorway & soccer camp host university for any cost or expense associated therewith.

I understand that activities, of which I will voluntarily take part, can be dangerous and may cause or lead to injuries, including but not limited to, broken bones, concussions, comatose state and other very serious bodily injuries up to and including death. I acknowledge that I am sufficiently fit to voluntarily participate, and that I may examine the equipment and facilities. If it appears to be unsafe, I will notify the appropriate party and not use the equipment of facilities until such condition is corrected. My participation shall be conclusive proof that I was satisfied with the safety and condition of the equipment and premises.

I hereby consent that college doorway or its agent may arrange for or provide emergency medical care that appears reasonably necessary, or transportation to such care. I understand and agree that neither college doorway nor soccer camp host university, nor its trustees, officers, employees, or agents shall provide medical insurance, nor will they pay any medical cost or expense incurred by me. I shall be responsible for the payment of all such expenses, including the costs of transportation or hospitalization. College Doorway, therefore, strongly recommends that I obtain my own personal insurance fit to cover any related injuries or damage, and I hereby acknowledge that recommendation.

I agree that this Agreement shall be binding on my personal representatives, assigns, heirs, next of kin and successors in interest whether such injuries or losses are alleged to be caused in whole or in part by the negligence of the released parties. In witness whereof, I affix my signature below.

III - NCAA Compliance and Eligibility: College Doorway operates in accordance with NCAA eligibility guidelines and does not provide recruiting or scouting services to perspective NCAA student-

athletes. College Doorway ID camp expenses are paid by participant fees to cover cost of attendance at the host university. To reaffirm, College Doorway does not receive commission from any

NCAA University related to enrollment of athletes and is aware of NCAA Bylaw 12.3.3 (Athletics Scholarship Agent) and does not guarantee students who attend the camp a scholarship at an NCAA institution.

IV - ACKNOWLEDGEMENT OF RULES AND STANDARDS OF CONDUCT: I understand that college doorway has rules and standards of conduct that are set forth in the Participants Manual. I agree to abide by these rules and standards for the safety of all participants, guests and employees.

V - ACKNOWLEDGMENT OF UNDERSTANDING: Participant and Parent/Guardian have read this agreement to participate and fully understand its terms. Participant and Parent/Guardian acknowledge freely and voluntarily signing the agreement to participate and intend the signatures to signify a complete assumption of the inherent risks of participating in or observing activities at college doorway soccer camp to the greatest extent allowed by law in the State of Florida.

Participant and Parent/Guardian have read this Agreement and fully understand its terms. In signing this Agreement each acknowledges that he or she is consenting to the Participant’s participation at college doorway soccer camp (as specified in article one) and acknowledge that each participant and Parent/Guardian expressly assumes all inherent risks of college doorway soccer camp activities.

NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN Read this forms completely and carefully. You are agreeing to let your minor child engage in a potentially dangerous activity. You are agreeing that, even if use of reasonable care in providing this activity, there is a chance your child may be seriously injured by participating in this activity because there are certain dangers inherent in the activity which cannot be avoided or eliminated. By signing this form you are giving up your child’s right and your right to recover from college doorway in a lawsuit for any personal injury, including death, to your child or any property damage that results from the risks that are a natural party of the activity. You have the right to refuse to sign this form, and college doorway has the right to refuse to let your child participate.

Participant and Parent/Guardian acknowledge that they are signing the agreement freely and voluntarily, and intend their signatures to be a complete and unconditional release of all liability to the greatest extent allowed by law.