Columbus Day Camp

CONSENT FORM FOR THE USE OF PHOTOGRAPHS AND VIDEO RECORDINGS

I hereby grant ProSoc Academy permission to use photographs and/or video recordings of my child on its website, in newsletters, on social media channels, or in other publications.

ProSoc Academy is also authorized to share these recordings with newspapers, television stations, or other media outlets so that they may be used in reports or news stories about ProSoc Academy.

I acknowledge that only ProSoc Academy is authorized to use these recordings. I do not grant permission for other organizations to use the recordings. ProSoc Academy is not authorized to sell the recordings.

I hereby release ProSoc Academy, as well as its officers and employees, from any legal responsibility or liability in connection with the publication of these recordings.

I understand that I may revoke this consent at any time, provided that no actions have already been taken based on this consent.

MEDICAL RELEASE FORM:

Recognizing the possibility of physical injury associated with soccer and in consideration for

ProSoc Academy and its affiliates accepting the registrant for its soccer programs and

activities (the “programs”), I hereby release, discharge and/or otherwise indemnify ProSoc

Academy, its affiliate organizations and sponsors, their employees and associated personnel,

including the owners of the fields and facilities utilized for the programs against any claim by

or on behalf of the registrant as a result of the registrant’s participation in the programs

and/or being transported to or from the same, which transport I hereby authorize.

My son/daughter has received a physical examination by a physician and has been found

physically capable of participating in the programs.

I hereby give my consent to have an athletic trainer and/or Doctor of Medicine or dentistry

provide my son/daughter with medical assistance and/or treatment and agree to be

responsible for the cost of such assistance and/or treatment.

I understand that I may revoke this authorization at any time, except to the extent that

action based on this authorization has already been taken.

I have reviewed the document or text above and understand that by checking this box I am acknowledging that I have read and understood its contents and, where applicable, agree to be bound by its terms. I also consent to the use of electronic records and signatures and understand that my acknowledgment provided electronically has the same legal effect as a handwritten signature.

We require a VAT Form for the ODP District training payment. Please submit one on your first session.

I will make sure to provide VAT Forms to ProSoc for the ODP District training. If VAT forms are not submitted

to ProSoc staff during the collection week, a Missing VAT Fee (19%) will be added to your account.