614 Soccer LLC

1696 Dyer Road, Grove City, OH 43123

[email protected]

Player Information

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Parent / Guardian Information

In an Emergency, when parents cannot be reached, please contact:

WAIVER OF LIABILITY, RELEASE & INDEMNIFICATION - Players 18 years of age must sign

I/We, the undersigned do voluntarily give permission for our child to participate in all 614 Soccer

LLC activities. I/We do hereby assume full responsibility for any risk of bodily injury, personal

injury or mental injury or death due to my/our child’s participation in any such activities and the

necessary travel to and from any activity site. I/We also further hereby assume full responsibility

for all lost, stolen, or damaged personal property and will not hold the 614 Soccer LLC, or its

employees, responsible for said loss or damage to personal property. The undersigned further

release, waive, discharge, indemnify and covenant not to sue 614 Soccer LLC, its individual

members, employees, agents or anyone acting on its behalf, from all liability, arising from or by

reason of any bodily injury, personal injury or mental injury, known or unknown, including death,

resulting from, or to result from my/our child’s participation in any 614 Soccer LLC activity. I/We

expressly agree that this release is intended to be as broad and inclusive as permitted by the

laws of the State of Ohio or any other state in which I/our child may be injured, and that if any

portion of this release is determined to be invalid, it is agreed that the remaining provisions of this

release shall continue in full force and effect. I/We further state that I/we have fully and carefully

read the above release, understand the contents of the same and sign this release voluntarily and

as my/our own free act and deed.

Also, In partnership with LiveBarn, this venue is equipped with video cameras for commercial purposes, including the online broadcast of events herein. By entering this venue, all participants and patrons waive any claim relating to the capture or public transmission of their participation while at the venue.

For LiveBarn's privacy policy go to https://www.livebarn.com/privacy-policy

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