I, the legal guardian of the registrant grant permission for him/her to participate fully in the activities of the Goalkeeper HQ soccer program. I hereby give my full permission to the physician or emergency medical
personnel selected by the coaching staff, administrators or representatives of Goalkeeper HQ to order x-rays, tests and treatment for my child. In the event that I cannot be reached in an emergency I hereby give permission to the physician or emergency medical personnel selected by the coaching staff, administrators or representatives of Goalkeeper HQ to hospitalize and secure proper treatments, and to order injection and/or anesthesia and/or surgery for my child. I expect every effort will be made to contact me in order to receive my authorization before
any treatment or hospitalization is undertaken.
I further agree to release and discharge “Goalkeeper HQ et al” and any other parties,
included but not limited to, providers of transportation for the children, including the use of their
own vehicles, their heirs, administrators, executors, successors, and assigns from, and hold
them harmless against all claims actions, causes of action, suits, damages, and any liability of
any kind whatsoever, arising out of my son/daughter’s participation in “Goalkeeper HQ et
al” activities and programs, including but not limited to, the transportation of my son/daughter to
and from activities by persons using their own vehicles or hired vehicles or by public transport.
I also agree that any photographs, video, or any other recordings of any Goalkeeper HQ
event may be used for publicity, advertising or any other legitimate purpose.