Midwest Showcase: Lou Fusz Winter Spotlight | Rush College Advisory Program

Players Name*

First Last

Player Date of Birth*

Birth Year*

Gender*

Female

There are no more spots for boys

Rush Club*

Main Position*

Forward
Center Mid
Wing Mid
Center Back
Outside Back
Keeper

Select One

Secondary Position*

Forward
Center Mid
Wing Mid
Center Back
Outside Back
Keeper

Select One

Jersey Number*

Players Email*

Players Phone Number*

Parents Email*

Parents Phone Numner

I have read the below Waiver*

Yes

Recognizing the possibility of physical injury associated with soccer and/or the sudden illness at an event, and in consideration for Rush Soccer and its affiliates accepting the registrant for its soccer programs and activities (the 'Programs'), I hereby release, discharge and/or otherwise indemnify Rush Soccer, its affiliated 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/from the same, which transportation I hereby authorize. My son/daughter has received 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, emergency personnel, and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of such assistance and/or treatment. In addition I acknowledge that there is an inherent risk of exposure to COVID 19. Since the event is taking place in public, by attending the event, I assume all risks related to COVID 19.

Comments

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