JCSPORTS INDOOR SOCCER LEAGUE
Contact: Jermaine (416) 3177979 or e-mail: firstname.lastname@example.org
2011 Waiver, Release of Liability, Indemnification and Consent Form
JCSPORTS INDOOR SOCCER LEAGUE – PLAYER / TEAM
WAIVER/APPLICATION FORM 2011 SEASON
Leagues start date: 29th September 2011 Leagues stop date: 1st December 2011
Cost per player: $125 Team Cost: $1000
Location: Terrasport Inc. 149 Rowntree Dairy Road Unit B, Woodbridge, ON L4L 6E1
Season games: 10 games for each team (50 minute games)
Players per team: 10 players
LEAGUE: DIVISION:(select one) DATE:
JCSPORTS INDOOR SOCCER LEAGUE DIVISION 1(recreational) and PREMIER(competitive)
Full Mailing City Postal Phone D.O.B Signature Email
Name Address Code Number (d/m/y)
In consideration of the right to use this facility and participate in the JCSPORTS INDOOR
SOCCER LEAGUE, I, or my heir, next of kin, successor, personal representative or assign agree
to assume all risks, discharge and hold harmless JCSPORTS RECRUIT AND JCSPORTS
INDOOR SOCCER LEAGUE and/or all other parties, owners, agents, operators having an
interest in this facility from all claims, liabilities, negligence, demands, changes and damages of
every kind or causes of actions arising from any connection which may arise out of my
participation in the activity at this facility. I will play under control, at all time, within the
rules of the game and to the best of my ability. I will avoid causing injury to myself and others
using this facility.
**NOTICE: Your safety is important. There is a potential risk in training and participating in any
sport, and JCSPORTS RECRUIT AND JCSPORTS INDOOR SOCCER LEAGUE have tried to
create a safe and playable environment. The Primary Contact (i.e. coach) is in agreeance
regarding stated rules for participation; and proper conduct on, off and about the playing field
must be followed at all time.
**I, the undersigned, player, acknowledge, agree, understand and declare that:
**I understand that participating in the sport of soccer involves some personal risks such as
injuries, and I am willing to assume these risks. Therefore, I understand that medical insurance is
my own responsibility. If medical treatment is necessary; I consent to all emergency medical
treatment as may be deemed appropriate under existing circumstances by medical personnel or
personnel associated with the JCSPORTS INDOOR SOCCER LEAGUE.
** I agree that in consideration for the right to allow me as a member of the JCSPORTS
INDOOR SOCCER LEAGUE designated below and in consideration for permission to play at
the site arranged for league:
I. I accept all risks of injury incurred or suffered (a) while playing as a member of a desired
team (b) while on or upon the premises of any and all of the facilities arranged for the
league for play (c) while serving in a non-playing capacity as a team member or observer
during practice or play by other teams or by other players on a desired team, and (d)There
is a possibility of Other Risks not known or not reasonably foreseeable; and
understanding all of the above.
II. In addition to giving my full consent for participation in the JCSPORTS INDOOR
SOCCER LEAGUE, I do hereby waive, release, discharge and agree not to sue desired
team and league designated below, the owner or operator of any sites or other entity
designated below, JCSPORTS RECRUIT, JCSPORTS INDOOR SOCCER LEAGUE,
TERRASPORT INC and all their employees, officials and volunteers, Permit &
Insurance Vendors, and/or all other parties, agents, having an interest in the facility of
any claims, damages, costs including attorneys fees, or cause of action which I may have
in the future as a result of damages, injuries, including death, sustained or incurred by my
participation from whatever cause including but not limited to the negligence, breach of
contract or wrongful conduct of the parties hereby released.
**I certify that I am capable of playing the sport of soccer, I am in good physical condition and
healthy with no physical or mental disabilities, infirmities, or injury that would stop me from
fully participating in activities related to the League.
**I further agree on behalf of myself listed below, that I shall hold harmless and fully indemnify
the parties hereby released from any and all claims, damages, costs including attorney fees, and
causes of action which may arise from any cause of action made by me, even if the damages,
injuries or death are caused in whole or in part by any of the persons (excluding league players)
or entities hereby released.
I hereby release the JCSPORTS RECRUIT and the TERRASPORT INC, Permit & Insurance
Vendors, and all its affiliates of any liability of any kind. I also understand that the
TERRASPORT INC & Permit Vendors are not affiliated with the league in any way except for
providing the facilities on a rental basis.
**I agree to abide by all the rules set out by the JCSPORTS INDOOR SOCCER LEAGUE. I
understand that the rules can be changed without notice at the discretion of the league conveners.
I also agree to abide by all the rules that are otherwise implied. The league will follow the
International Federation of Association Football and JCSPORTS RECRUIT rules where
applicable, and at the discretion of the referee.
**I understand that I can be disqualified or ejected from the JCSPORTS INDOOR SOCCER
LEAGUE for not abiding by the rules, or acting in a manner that is detrimental to the league in
any way, at the discretion of referees or league management.
**Important: Player and Team Photo ID will be checked during, before or after games.
The league will consist of two competitive divisions (Division 1 and Premier)
Teams must use only players who are registered on game sheet except as otherwise stipulated.
Failure to do so will result in that team’s disqualification.
a) No limit to the number of substitutions that may be made during a game.
b) Substitutions may be made at any stoppage in play, subject to the discretion of the referee
c) Player(s) ejected from game play cannot be substituted back into game. Player(s) cannot
take to the pitch for remainder of the match, and must leave playing area immediately.
Game Times and Offences
Teams must arrive 20 minutes before game time to be properly and thoroughly checked in.
Yellow cards receive a 5-10 minute break while Red cards mean an immediate ejection from
the game. Yellow cards and red cards are not dependent on goals scored, and will be enforced
for full duration of allotted time or match.
Participant Name (print) Participant Signature Date