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Team: Slam City Gorillas-Richardson
Team: City Onions - Richardson/Carrollton
Team: PST - Richardson/Dallas

LIABILITY RELEASE: I, the parent/guardian of the above named “Player”, a minor, agree that the Player and I will abide by the rules of the City Futsal, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for City Futsal accepting the Player for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify the City Futsal, its affiliated organizations and sponsors, their employees, associated personnel and volunteers as a result of the Player’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize. I further grant City Futsal the right to use my electronic signature, the player’s name, pictures and /or likeness in printed, broadcast, and other material concerning the Programs provided such use is related to the Player’s status as a participant in the Programs.

CONSENT FOR MEDICAL TREATMENT (MINOR) I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.

Consent for Medical Treatment and Liabiity release