* ACCIDENT WAIVER AND RELEASE OF LIABILITY I hereby assume all of the risks of my child participating in Florida Premier FC SWFL / Braden River SC , Including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained or controlled by them, or because of their possible liability without fault. I certify that my child is physically fi t and has not been advised to not participate by a qualifi ed medical professional. I certify that there are no health-related reasons or problems which preclude my child’s participation in this program. I acknowledge that this Accident Waiver and Release of Liability Form will be used by Florida Premier FC SWFL / Braden River SC so my child may participate and that it will govern my actions and responsibilities at said FL Premier FC SWFL / Braden River SC events. In consideration of my registration and by permitting my child to participate in FL Premier FC SWFL / Braden river SC events, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A)I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my child’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me or my child including traveling to and from this Clinic.

FOLLOWING ENTITIES OR PERSONS: Florida Premier FC SWFL / Braden River SC, and/or their coaches, agents, representatives or volunteers. (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this Clinic, whether caused by negligence or otherwise. I acknowledge that this program may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, and lack of hydration. I consent and agree that Florida Premier FC SWFL / Braden river SC, and/or their coaches, agents, representatives or volunteers may take photographs or digital recordings of me or my child as a participant during this event and use these in any and all media for training or promotional purposes. I waive any rights, claims or interest and I understand that there will be no financial or other remuneration. The accident waiver, release of liability and image release shall be construed broadly to

provide a release and waiver to the maximum extent permissible under applicable law. PARENT/GUARDIAN

WAIVER FOR MINORS (under 18 years old) The Undersigned parent and or natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in FL Premier FC SWFL / Braden river SC events, and has agreed individually and on behalf of

the child or ward, to the terms of the accident waiver and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all

parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect on lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND

I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON MY OWN FREE WILL. THIS AUTHORIZATION SHALL REMAIN IN EFFECT FOR ONE YEAR FROM THE DATE IT WAS SIGNED

Recognizing the possibility of injury or illness, and in consideration for US Youth Soccer and members of US Youth Socceraccepting 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 otherwiseindemnify 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 playerson/daughter as a result of my son's/daughter’s participation in the Programs and/or being transported to or from thePrograms. 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 physicallycapable of participating in the sport of soccer. I have provided written notice, which is submitted in conjunction with thisrelease and attached hereto, setting forth any specific issue, condition, or ailment, in addition to what is specified above, thatmy child has or that may impact my child's participation in the Programs. I give my consent to have an athletic trainer and/orlicensed medical doctor or dentist provide my son/daughter with medical assistance and/or treatment and agree to befinancially responsible for the reasonable cost of any such assistance and/or treatment. 

FLORIDA YOUTH SOCCER ASSOCIATION CONCUSSION INFORMED CONSENT

Pursuant to Florida Statute 943.0438, this form must be signed by all youth participants and parent/legalguardians before participating in athletic competition or engaging in any practice, tryout, workout, or otherphysical activity associated with the youth’s candidacy for an athletic team.

Concussion Information

A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to thehead, or by a blow to another part of the body with the force transmitted to the head. Concussions can range frommild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, allconcussions are potentially serious and may result in complications including prolonged brain damage and deathif not recognized and managed properly. In other words, even a "ding" or a “bump” on the head can be serious.You cannot see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If yourchild reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seekmedical attention right away.

Signs and Symptoms Observed by Parents or Coaches

• Appears dazed or stunned.• Forgets an instruction, is confused about an assignment or position, or is unsure of the game,

score, or opponent.• Moves clumsily.• Answers questions slowly.• Loses consciousness (even briefly).• Shows mood, behavior, or personality changes. • Can’t recall events prior to or after a hit or fall.

Symptoms Reported by Youth Participants

• Headache or “pressure” in head.• Nausea or vomiting• Balance problems or dizziness, or double or blurry vision. • Bothered by light or noise.• Feeling sluggish, hazy, foggy, or groggy.• Confusion, or concentration or memory problems.• Just not “feeling right,” or “feeling down.”

What can happen if my child keeps on playing with a concussion or returns too soon?

Youth participants with the signs and symptoms of concussion must be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the youth participant especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period oftime after that concussion occurs, particularly if the youth participant suffers another concussion before completely recovering from the first one (second impact syndrome). This can lead to prolonged recovery, or evento severe brain swelling with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often under report symptoms of injuries, and concussions are no different. As a result, education of administrators, coaches, parents and players are the key for youth participant’s safety.

If you think your child has suffered a concussion

No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems orhow quickly symptoms clear, without written medical clearance from a Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) who is familiar with the Close observation of the youth participant should continue for several hours. Parent/Legal guardian should also inform their child's coach if they suspect their child may have a concussion. Remember it is better to miss one game than miss the whole season. When in doubt, the youth participant sits out! 

Return to Practice and Competition 

The Florida Youth Soccer Association follows Florida Statute 943.0438, provides that if an athlete suffers, or is suspected of having suffered, a concussion or head injury during a competition or practice, the youth participant must be immediately removed from the competition or practice and cannot return to practice or competition until a Health Care Professional has evaluated the youth participant and provided a written authorization to return to practice and competition. FYSA recommends that a youth participant not return to practice or competition the same day the athlete suffers or is suspected of suffering a concussion. FYSA also recommends that a youth participant's return to practice and competition should follow a graduated protocol under the supervision of the health care provider (MD or DO). 

For more information from the CDC on concussions you can go to: https://www.cdc.gov/headsup/youthsports/index.html