Minnesota Emergency Information Consent Form
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MINNESOTA YOUTH SOCCER ASSOCIATION
Emergency Information Consent Form
Name of Registrant _______________________________ _______ ___________________________________
First

Initial

Last

Club ________________________ Team Name ____________________________________________________
Parent/Guardian Agreement
I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the USYSA and
the MYSA, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer
and in consideration for the USYSA and MYSA accepting the registrant for its soccer programs and activities (the
“programs”), I hereby release, discharge and/or otherwise indemnify the USYSA and MYSA, its affiliated organizations
and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the
Programs, against any claim by or on behalf of the registrant as a result of the registrant’s part