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Assessment no:

League Use Only

Doha Soccer League


2017 Season Registration Form

Return the completed form on Saturday, November 5 th 2016 or email to


dohasoccer@yahoo.com
Player Name:
Birth date:

(dd.mm.yy)

Student of ASD:

yes / no

Grade:

Gender:

male / female (please circle)

Football shirt size:


Illness, injuries or special conditions that Doha Soccer League should be aware of?
yes / no
If YES, please indicate condition: __________________________________________

Parents Information and contacts: (Please fill in as legibly as possible)


Fathers Name __________________________
Mo
bile: _____________________________
Mothers Name __________________________
M o bile: ____________________________

Email Address
Emergency contact person and number:
(other than parent)
Volunteers needed for coaches and assistant coaches or general assistance

I am willing to coach my childs team.

I am willing to be an assistant coach for my childs team.

I am willing to otherwise help with my childs team

L EAGU E USE ONLY


Fees paid:

yes / no

Waiver submitted: yes / no

DOHASOCCERLEAGUEWAIVEROFLIABILITY,ASSUMPTIONOFRISKANDINDEMNITY
ANDPARENTALCONSENTAGREEMENT

FamilyName____________________________________Address_________________________________________Phone(H)___________________
InconsiderationofmychildbeingpermittedtoparticipateintheDohaSoccerLeaguesocceractivitiesatASD(Activity),bysigningthisagreementI,
...................................fullyunderstandthat:(a)socceractivitiesinvolverisksanddangersofseriousbodilyinjury,includingpermanentdisability,paralysis,and
death(Risks);(b)theseRisksanddangersmaybecausedbymychildsactionorinaction,theactionsorinactionsofothersparticipatingintheActivity,the
conditioninwhichtheActivitytakesplace,ornegligenceoftheReleaseesnamedbelow;(c)theremaybeotherriskandsocialandeconomiclosseseithernot
knowntomeornotreadilyforeseeableatthistime;andIfullyacceptandassumeallsuchRisksandallresponsibilitiesforlosses,costs,anddamagesIincurasa
resultofmychildsparticipation.
AndI,thechildsparentand/orlegalguardian,understandthenatureofsocceractivitiesandthechildsexperienceandcapabilitiesandbelievethechildtobe
qualified,ingoodhealthandinproperphysicalconditiontoparticipateinsuchactivity.IfurtheragreeandwarrantthatifatanytimeIbelieveconditionstobe
unsafe,IwillimmediatelydiscontinuefurtherparticipationintheActivitybymychild.IherebyRELEASE,DISCHARGE,COVENANTNOTTOSUEtheDoha
SoccerLeague,soccercoaches,ASD,theirrespectiveadministrators,directors,agents,officers,members,volunteers,andemployees,otherparticipants,any
sponsors,advertisers,andifapplicable,ownersandlessorsofpremisesonwhichtheActivitytakesplace,(eachconsideredoneoftheReleaseesherein)fromall
liability,claims,demands,losses,ordamagescausedorallegedtobecausedinwholeorpartbythenegligenceoftheReleaseesorotherwise,includingnegligent
rescueoperationandfurtheragreethatif,despitethisrelease,ImakeaclaimagainstanyoftheReleaseesnamedabove,Iwillindemnify,saveandholdharmless
eachoftheReleaseesfromanylitigationexpenses,attorneyfees,loss,liability,damage,orcostasmayincurastheresultofanysuchclaimandagreeto
indemnifyandsaveandholdharmlesseachoftheReleaseesfromaccountcausedorallegedtobecausedinwholeorinpartbythenegligenceoftheReleaseesor
otherwise,includingnegligentrescueoperation.
ASDRELEASEANDWAIVEROFLIABILITY,ASSUMPTIONOFRISK,ANDINDEMNITY
ANDPARENTALCONSENTAGREEMENTCONTINUATION
Ihavereadthisagreement,fullyunderstanditsterms,understandthatIhavegivenupsubstantialrightsbysigningitandhavesigneditfreelyandwithout
inducementorassuranceofanynatureandintendittobeacompleteandunconditionalreleaseofallliabilitytothegreatestextentallowedbylawandagreethatif
anyportionofthisagreementisheldtobeinvalidthebalance,notwithstanding,shallcontinueinfullforceandeffect.
PrintedNameofPlayer

PrintedNameofParent/Guardian

ParentSignature

Date

_____________________________

_______________________________ _______________________

___________________

_____________________________

______________________________________________________

___________________