One form. One secure record.

I authorize the participant identified in this form to take part in Balboa Soccer Group, Inc. practices, training sessions, clinics, games, tournaments, community events, and related activities (collectively, the Activities). I certify, to the best of my knowledge, that the participant is physically able to participate safely. I have disclosed known medical conditions, allergies, medications, injuries, and limitations that may affect participation. I understand that BSG does not make medical determinations and that I should obtain medical advice when appropriate. I give permission to participate and accept responsibility for determining medical fitness.

I understand that soccer and related athletic, recreational, volunteer, and event activities involve inherent and other risks. These include, without limitation: running, jumping, falls, slips, collisions, physical contact, contact with balls, goals, equipment, participants, coaches, officials, spectators, vehicles, or fixed objects; uneven or defective playing surfaces; weather, heat, cold, sun exposure, dehydration, overexertion, and communicable illness; equipment failure; travel separately authorized; and the acts or omissions of other participants or third parties. These risks may cause property damage, emotional distress, illness, sprains, strains, fractures, concussion or other head injury, cardiac events, permanent disability, paralysis, or death. I knowingly and voluntarily accept all inherent and reasonably foreseeable risks of participation, whether known or unknown, on behalf of myself and, if applicable, the minor participant.

To the fullest extent permitted by law, I agree to indemnify and hold the Released Parties harmless from third-party claims, losses, or reasonable expenses caused by the participant's intentional or negligent conduct, violation of communicated safety rules, or my material breach of this agreement. This provision does not require indemnification for a Released Party's gross negligence, reckless or intentional misconduct, fraud, or violation of law.

If an emergency occurs and I cannot be reached promptly, I authorize BSG representatives to contact 911, provide reasonable first aid within the limits of their training, and obtain or arrange reasonably necessary emergency transportation, evaluation, or treatment for the participant. BSG will make reasonable efforts to contact the adult participant or the minor's parent/guardian and the listed emergency contact as soon as practical. No person is required to provide care beyond their training or legal authority. I accept responsibility for resulting medical and transportation expenses not paid by insurance. I understand that BSG does not promise or guarantee participant-accident or medical insurance unless BSG confirms coverage in writing.

The participant must immediately report injury, pain, dizziness, headache, confusion, fainting, shortness of breath, chest pain, or other concerning symptoms and stop participating when directed. An athlete suspected of a concussion or other head injury, or who faints or shows a suspected cardiac condition, must be removed from activity for the remainder of the day and may not return until evaluated and cleared in writing by an appropriately licensed healthcare provider. If a concussion is diagnosed, the athlete must complete a graduated return-to-play protocol of at least seven days under appropriate medical supervision, consistent with California law.

For youth participants, the BSG annual concussion/head-injury and sudden-cardiac-arrest information included below must be reviewed before practice or competition. The athlete and parent/guardian must acknowledge receipt as required by California Health and Safety Code section 124235. For athletes age six or younger, only the parent/guardian acknowledgment is required.

Declining media permission will not affect eligibility to participate. If YES is selected, I grant BSG and its authorized photographers a non-exclusive, royalty-free permission to photograph, record, or film the participant and to use the participant's name, image, likeness, or voice for BSG program, educational, community-outreach, fundraising, promotional, website, print, and social-media purposes without compensation. BSG will not intentionally publish home addresses, medical information, or private contact information. Permission may be revoked prospectively by written notice to registration@bsgsd.org, but revocation cannot require recall of materials already printed, published, or distributed.

Unless BSG expressly agrees otherwise in writing, the participant or parent/guardian is responsible for transportation to and from Activities. BSG-arranged transportation may require a separate written permission form. The participant agrees to follow communicated safety and facility rules, use appropriate equipment, act respectfully and sportsmanlike, and comply with reasonable instructions. Unsafe or seriously disruptive conduct may result in removal, suspension, or program dismissal.

This agreement is governed by California law. If any provision is found invalid or unenforceable, the remaining provisions will remain effective to the fullest extent permitted by law. This agreement is the complete participant waiver and consent for the covered Activities unless BSG provides an additional event-, league-, facility-, travel-, or insurer-required form. A waiver or consent may be changed only in a writing accepted by BSG. Headings are for convenience and do not limit the terms.

By signing, I certify that I have legal authority to sign for myself or the minor participant. I confirm that I have read this agreement, understand it, had the opportunity to ask questions, and sign voluntarily. I understand that I am accepting risks and giving up certain legal rights, including certain claims based on ordinary negligence. I will keep a copy for my records.