FC Batavia
Club Registration.

I, the parent/legal guardian of the below-named player, a minor, agree that I and the player will abide by the rules and regulations of the USYSA, its affiliated organizations and its sponsors (“USYSA Parties”). In consideration of the player’s participation in the soccer programs and activities, including but not limited to athletic and social events of the USYSA Parties (“the Programs”) and FC Batavia, I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the USYSA Parties and FC Batavia, owners, operators, coaches / trainers, independent contractors, the owners and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents, independent contractors and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player’s participation in the Programs including, without limitation, player’s transportation to/from any Program, which transportation is hereby authorized. I further grant the USYSA Parties and all above mentioned parties the right to use the player’s name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player’s status as a participant in the Programs. I hereby grant FC Batavia permission to use names / photograph(s) / video of the below named player and myself in any and all publications and all other media, whether now known or hereafter existing, in perpetuity, and for other use by FC Batavia. I will make no monetary or other claim against FC Batavia for the use of information and photograph(s) / video.

As the parent or legal guardian of the above named player, I hereby give consent for emergency Medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. I further request that in my absence the above named player be admitted to any hospital or medical facility for diagnosis/treatment. I authorize all diagnostic/treatment/operative/x-ray procedures of the above minor. I have not been given a guarantee as to the results of examination/treatment. I authorize disposal of any specimen or tissue taken from the above named player.