Registration

Heights FC Waiver of Liability, Assumption of Risk, Indemnity Agreement, and Appearance Agreement

In consideration of being permitted to participate in any way in:

Activity Name: Heights FC Soccer Clinic
Location: Ben Franklin Middle School, 540 Cerritos Ave, Long Beach, CA 90802
Dates: Listed on website when registering

Hereinafter called “Activity”, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue Heights FC and their employees. officers, directors, volunteers and agents (collectively “Heights FC”) from any and all claims including the negligence of Heights FC.; it’s officers, employees, and agents, resulting in personal injury, physical or psychological injury, accidents, or illnesses (including paralysis and death), damages, economical or emotional loss and property loss arising from, but not limited to, participation in Activity.

Assumption of Risks: I am voluntarily participating in this ActivityParticipation in Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions to 3) catastrophic injuries including paralysis and death. Nonetheless, I assume all related risks, both known or unknown to me, of my
participation in this Activity, including travel to, from and during the Activity. I have read this paragraph and I know, understand, and appreciate these and other risks that are inherent in the Activity. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.

Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD Heights FC HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages, liabilities, travel to, from and during Activity and attorney’s fees brought as a result of my involvement in the Activity and to reimburse them for any such expenses incurred.

Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

GOVERNING LAW: This Agreement will be governed by the laws of the State of California. Heights FC and I agree that any claims, legal proceedings, or litigation arising in connection with this Agreement will be brought solely in the courts of the County of Los Angeles, and the Parties consent to the jurisdiction of such courts. If any claim of dispute arising out of, or relating to, this Agreement is not settled promptly in the ordinary course of business, the Parties shall seek to resolve such dispute between them, first, by negotiating promptly in good faith. If a legal action is necessary to enforce this Agreement, the prevailing Party shall be entitled to reasonable attorney fees, costs, and expenses

Appearance Agreement: I understand that Heights FC creates or produces various media materials and presentations relating to the Heights FC Programs, in various mediums including, but not limited to photographs, video, audio recordings, websites, etc., (collectively “Program Media”)). I understand that as a Participant and/or spectator at the Heights FC Programs the Student may be included in Program Media taken. Therefore, without reservation or limitation, I, for myself and on behalf of the Student, hereby assign, transfer and grant to Heights FC a royalty free, non-exclusive and perpetual right, license and privilege to record Student in its Program Media and to utilize such Program Media and Student’s name, face, likeness, voice, and appearance as a part of the Heights FC Programs as well as in advertising or promoting the Heights FC Programs, now or in the future. I further understand that neither Heights FC, nor any third party, is under any obligation to exercise any of the foregoing rights, licenses and privileges.

Acknowledgment of Understanding: I have read this waiver of liability, assumption of risk, indemnity agreement, and appearance agreement, and fully understand its terms, and understand that I am giving up substantial rights including my right to sue including travel to, from and during the Activity. I acknowledge that I am signing the agreement freely and voluntarily and intend by my signature to be completed and unconditional release of all liability to the greatest extent allowed by law.

I ACKNOWLEDGE AND REPRESENT THAT I AGREE TO ALL OF THE TERMS OF THIS WAIVER, WARRANT MY REPRESENTATIONS ABOVE, AND I AM OVER EIGHTEEN (18) YEARS OLD, AND ACKNOWLEDGE AND EXPRESSLY AGREE THAT I HAVE NOT TESTED POSITIVE FOR COVID-19 IN THE LAST CALENDAR WEEK, DO NOT CURRENTLY HAVE SYMPTOMS SUCH AS COUGH OR SORE THROAT, AND WILL NOT ATTEND AN IN-PERSON ACTIVITY IF I HAVE ANY SUCH SYMPTOMS OR TEST POSITIVE FOR COVID-19.

Heights FC Concussion Awareness Release

(ADAPTED FROM THE CDC AND THE 3RD INTERNATIONAL CONFERENCE ON CONCUSSION IN SPORT)

A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t 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 your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.

Symptoms may include one or more of the following:

• Headaches, neck pain, amnesia, nausea or vomiting
• “Pressure in the head,” feelings of drowsiness
• Balance problems or dizziness
• Blurred, double, or fuzzy vision, sensitivity to light or noise
• Drowsiness, feeling sluggish or slowed down; foggy or groggy
• Irritability, confusion, or emotional confusion
• “Don’t feel right”
• Fatigue or low energy, sadness, nervous, or anxiety
• Concentration or memory problems
• Repeating the same questions/comment

Signs observed by teammates, parents and coaches include:

• Appears dazed, answers questions slowly
• Slurred speech
• Vacant facial expression
• Shows behavior or personality changes
• Confused about assignment or forgets plays
• Can’t recall events prior to hit or events after hit
• Moves clumsily or displays un-coordination
• Seizures, convulsions, or loss of consciousness
• Is unsure of game, score or opponent
• Any change in typical behavior or personality

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

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to sever brain swelling (second impact syndrome) 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 students is the key for a student-athlete’s safety.

If you think your child has suffered a concussion:

Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. The new “Zachery Lystedt Law” in Washington State now requires the consistent and uniform implementation of long and well-established return to play concussion guidelines that have been recommended for several years:

“A youth athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time.” AND “may not return to play until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and received written clearance to return to play from that health care provider.”

You should also inform your child’s coach if you think that your child may have a concussion. Remember it is better to miss one game than to miss the whole season. When in doubt, the athlete sits out! For current and up-to-date information on concussions you can go to: http://www.cdc.gov/ConcussionInYouthSports/

At Heights FC, concussions are taken very seriously and our coaches and volunteers have been educated on how to treat concussions while they participate in Heights FC events.