Edmonton Soccer Association
12720 Victoria Trail
Edmonton, AB, T5A 5G4

General Inquiries:
780-413-4125
Bookings:
780-413-4125 Ext. 1

Fax: 780-406-4976

Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it.

**If this waiver is for use with EDSA, EMSA, EIYSA or BHE, please contact the league you are registered with for waiver signing. Electronically signed waivers will not be accepted for individuals registered with the above leagues.

Please click here for the waiver in .pdf format, which will be accepted by all leagues, or can be dropped off in person at any of the below listed facilities.

 

 

MINOR UNDER 18 YEARS OF AGE

(*TO BE SIGNED BY PARENT OR GUARDIAN)

RELEASE OF LIABILITY, WAIVER OF CLAIMS

ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

BY SIGNING THIS DOCUMENT YOU ARE WAIVING CERTAIN LEGAL RIGHTS INCLUDING THE RIGHT TO SUE.

PLEASE READ CAREFULLY

I AM OVER THE AGE OF EIGHTEEN YEARS AND I AGREE THAT, IN CONSIDERATION of myself and the minor being permitted to enter and use any one or more of the following described lands and premises (including all facilities and equipment located therein) for any activities including but not limited to soccer, ball hockey, box lacrosse, lawn (carpet) bowling, and roller hockey, located on the lands and premises being,

a. The lands and premises of the City of Edmonton municipally described as 17415 – 106A Avenue which premises are leased to and operated by the Edmonton Soccer Association;

b. The lands and premises of the City of Edmonton municipally described as 12720 Victoria Trail which premises are leased to and operated by the Edmonton Soccer Association;

c. The lands and premises of the City of Edmonton municipally described as 6520 Roper Road which premises are leased to and operated by the Edmonton Soccer Association; and

d. The lands and premises of the City of Edmonton municipally described as 14920 – 142 Street, which premises are leased to and operated by the Edmonton Soccer Association;

I AGREE that I, the undersigned, on behalf of myself and the minor, our heirs, successors and assignors, HEREBY REMISE, RELEASE, INDEMNIFY, DISCHARGE, AND FOREVER HOLD HARMLESS the Edmonton Soccer Association (“the Association”), the City of Edmonton (“the City”), and the association(s)/league(s) organizing the game or event, their directors, employees, volunteers, coaches, instructors, agents and independent contractors and their heirs, successors and assignors from any claims whatsoever arising by reason of any disease, deterioration of health, illness or injury to any person, including death, or for damage to, or loss of any of my property resulting from or arising from use of the lands and premises, from being present on the lands and premises, from participation in any program, from the use of any facilities or equipment located on the lands and premises, from acceptance of the advice of, or from the negligence of the Association, the City and the association(s)/league(s) organizing the game or event, their directors, employees, volunteers, coaches, instructors, agents, independent contractors or any other persons using the lands and premises.

The above information is being collected by or on the behalf of Edmonton Soccer Associations (ESA) in accordance with PIPA (Personal Information and Protection Act). The information is being collected for the sole purpose(s) of administering insurance claims and liability. In the event of an insurance claim, this information may be provided to the appropriate insurance company, Alberta Soccer Association or the league in which the individual is registered. Should you have any questions regarding the collection of your personal information please contact Edmonton Soccer Association, This e-mail address is being protected from spambots. You need JavaScript enabled to view it.

Waiver Minor17-18

 

Please fill out the fields below to submit an electronically signed waiver.
*I have read the above waiver contract and agree to the terms and conditions.
Please note – only the parent or legal guardian may accept this waiver on behalf of the child.
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