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Northridge Soccer Academy
7-A-Side Team Waiver
Consent & Assumption of Risk Form

Print, fill in, and mail to:
Northridge Soccer Academy
CSUN Athletic Dept/Derek Hankst
18111 Nordhoff Street
Northridge, CA 91330-8276


I am willing to participate in the Northridge Soccer Academy Annual 7-A-Side Soccer Tournament. In signing this form, I acknowledge the physical demands of the sport of soccer and do personally release, hold harmless and forever discharge the Northridge Soccer Academy, the University, and the State of California from all claims, causes of action, or liability by reason of any reason of any injury to person or property with the participation in this tournament. This is verified by my signature below. If I am below the age of 18, this form is signed and dated by my parent or legal guardian.

DIVISION (circle one): MEN | WOMEN

TEAM NAME: ________________________________________ DATE: __________________


TEAM CONTACT (name, phone #, and e-mail):

_____________________________________________________________________________________

Player Name (print) Age Signature Email Address Phone#
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______________________________ ____ _______________________ _______________ ____________
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