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IYSA U12
Registration Form
(Birthyears - 2013 through 2014)

 

Please fill out all required (*) fields below and click on "Proceed to Checkout"

Player Gender

Informed Consent Policy and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by the Ithaca Youth Soccer Academy during the selected season. In exchange for the acceptance of said child’s enrollment in the Club programs, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless the Ithaca Youth Soccer Academy and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against the Ithaca Youth Soccer Academy, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including soccer

I, as parent/guardian with legal responsibility for this participant, do acknowledge my responsibility to restrict my child from play or practice if they exhibit any symptoms of COVID-19, and consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.

Photography Consent

At Ithaca Youth Soccer Academy, we love capturing the energy, teamwork and excitement that make our soccer community so special! You might see us taking photos and videos of our amazing teams during practices, games and other IYSA related events on our website, social media or in other promotional materials.

By being part of IYSA, you're agreeing to let us use these images, videos, etc. to help show off the wonderful things our teams are doing and there won't be any payment for them.

If you have questions or concerns, please feel free to reach out to us.

Thanks for being part of our community!

2019 © Ithaca Youth Soccer Academy

Field Address: Outdoor - 1767 East Shore Drive Ithaca, NY 14850

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