Parental Consent &Waiver Form

(Complete, print, and mail with Registration Form and check)
 

     I hereby grant permission for my child, _______________________, to attend the Mid-Michigan Soccer Academy camp and verify that my child has received a physical examination within the past year and is physically capable to participate in the activities related to the camp.  In case of emergency, I hereby authorize the Mid-Michigan Soccer Academy staff to act for me according to their best judgment in any emergency requiring medical attention, and I hereby waive and release the camp, Saginaw Township Soccer Association, and/or its staff from any and all liability for injury or illness to my child. 

  

Please Sign    ___________________________________________Date:_________ (Must be signed by parent or legal guardian if athlete is under 18 years of age.) or ___________________________________________Date:_________ (Athletes signature if athlete is 18 or older) Insurance Carrier:___________________________ Allergies:_________________________________

  

Please complete and sign this Parental Consent & Waiver Form, and mail it to MMSA along with your check and Registration Form (if not submitted online). Please see the Registration Form for address and fee information.