San Antonio Runners

Community • Leadership • Professionalism

2023 Women's Registration Form

2023 SA Runners Womens Soccer Registration

<form-template>
	<fields>
		<field type="header" subtype="h1" label="SAN ANTONIO RUNNERS 2023 WOMENS SOCCER REGISTRATION FORM" class="header"></field>
		<field type="checkbox" required="true" label="By checking this box I confirm I have read the entire 2023 SA Runners Player Handbook before completing this form and payment." class="checkbox" name="by-checking-this-box-i-confirm-i-have-read-the-entire-2023-sa-runners-player-handbook-before-completing-this-form-and-payment" value="on"></field>
		<field type="text" required="true" label="By signing below I confirm I have read the SA Runners Player Code of Conduct and I agree to follow SA Runners Code of Conduct during the contracted term." subtype="text" class="form-control" name="by-signing-below-i-confirm-i-have-read-the-sa-runners-player-code-of-conduct-and-i-agree-to-follow-sa-runners-code-of-conduct-during-the-contracted-term-"></field>
		<field type="header" subtype="h3" label="Runners Waiver" class="header"></field>
		<field type="text" required="true" label="By signing below  I consent to the Participant's participation in San Antonio Runners Soccer Club  Inc. Activities and I certify that there is no medical reason why Participant should not participate in SA Runners Activities. I acknowledge that the nature of the Activities may expose Participant to hazards or risks that may result in Participant's illness  personal injury or death  and I understand and appreciate the nature of such hazards and risks.  In consideration of Participant being permitted to participate in SA Runners Activities  I hereby accept all risk to Participant's health  including an injury or death to Participant that may result from such participation  which participation includes all travel associated with SA Runners Activities  and I hereby release San Antonio Runners Soccer Club  its governing board, officers, representatives, employees and agents from any and all liability to Participant, Participant's personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to Participant's property and for any and all illness or injury to Participant's person, including his or her death, that may arise from or occur during Participant's participation in SA Runners Activities, WHETHER CONTRIBUTED TO OR CAUSED BY ANY NEGLIGENCE OF SAN ANTONIO RUNNERS SOCCER CLUB, ITS GOVERNING BOARD, OFFICERS, EMPLOYEES OR REPRESENTATIVES, OR OTHERWISE.  I further agree to indemnify and hold harmless San Antonio Runners Soccer Club, its governing board, officers, representatives, employees and agents from liability for the injury or death of any person(s) and damage to property that may arise, in whole or in part, from Participant's negligent or intentional act or omission while participating in SA Runners Activities, WHETHER CONTRIBUTED TO OR CAUSED BY ANY NEGLIGENCE OF SAN ANTONIO RUNNERS SOCCER CLUB, ITS GOVERNING BOARD, OFFICERS, EMPLOYEES OR REPRESENTATIVES, OR OTHERWISE." subtype="text" class="form-control" name="by-signing-below--i-consent-to-the-participants-participation-in-san-antonio-runners-soccer-club-inc-activities-and-i-certify-that-there-is-no-medical-reason-why-participant-should-not-participate-in-sa-runners-activities-i-acknowledge-that-the-nature-of-the-activities-may-expose-participant-to-hazards-or-risks-that-may-result-in-participants-illness-personal-injury-or-death-and-i-understand-and-appreciate-the-nature-of-such-hazards-and-risks--in-consideration-of-participant-being-permitted-to-participate-in-sa-runners-activities-i-hereby-accept-all-risk-to-participants-health-including-an-injury-or-death-to-participant-that-may-result-from-such-participation-which-participation-includes-all-travel-associated-with-sa-runners-activities-and-i-hereby-release-san-antonio-runners-soccer-club-its-governing-board-officers-representatives-employees-and-agents-from-any-and-all-liability-to-participant-participants-personal-representatives-estate-heirs-next-of-kin-and-assigns-for-any-and-all-claims-and-causes-of-action-for-loss-of-or-damage-to-participants-property-and-for-any-and-all-illness-or-injury-to-participants-person-including-his-or-her-death-that-may-arise-from-or-occur-during-participants-participation-in-sa-runners-activities-whether-contributed-to-or-caused-by-any-negligence-of-san-antonio-runners-soccer-club-its-governing-board-officers-employees-or-representatives-or-otherwise--i-further-agree-to-indemnify-and-hold-harmless-san-antonio-runners-soccer-club-its-governing-board-officers-representatives-employees-and-agents-from-liability-for-the-injury-or-death-of-any-persons-and-damage-to-property-that-may-arise-in-whole-or-in-part-from-participants-negligent-or-intentional-act-or-omission-while-participating-in-sa-runners-activities-whether-contributed-to-or-caused-by-any-negligence-of-san-antonio-runners-soccer-club-its-governing-board-officers-employees-or-representatives-or-1679798089976"></field>
		<field type="header" subtype="h3" label="UWS Waiver" class="header"></field>
		<field type="text" required="true" label="I acknowledge that soccer or any sporting event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury, or property loss. I recognize that I may be asked to practice for, participate in, and travel to and from soccer events on behalf of the team and I HERE BY ASSUME THE RISK OF PARTICIPATION IN THE SOCCER EVENT. WAIVER &amp; LIABILITY RELEASE FORM (FOR MINORS ONLY): I AM UNDER THE AGE OF EIGHTEEN (18) YEARS OLD. MY PARENT(S)/GUARDIAN HAS READ AND COMPLETED THE SECTION BELOW. (If the applicant is under 18 years of age, a parent or guardian must execute, in addition to the foregoing Waiver and Liability Release, the following, for and on behalf of the minor.) As the parent and natural guardian or legal guardian of ________________________________  (minor’s name) I hereby the forgoing Waiver and Liability Release for and on behalf of the named herein. I hereby bind myself, the minor and all other assigns to the terms of the Waiver and Liability Release. I represent that I have legal capacity and authority to act for and on behalf of the minor in the execution of the Waiver and Liability Release. I agree that prior to participating, I will inspect the facilities and equipment to be used and if I believe anything is unsafe, I will immediately advise the coach or supervisor of such condition(s) and refuse to participate. I hereby take the following action for myself, my executors, administrators, heirs, next of kin successors and assigns: I WAIVE, RELEASE, AND DISCHARGE from any and all claims or liabilities for death or personal injury or damages of any kind, which arise out of or relate to my participation in, or my traveling to and from the soccer event, THE FOLLOWING PERSONS OR ENTITIES: United Womens soccer (UWS); the Team for which I play; the Team Owner; any sponsors obtained by the Club or UWS; any Players or Coaches; any Officers, Directors, Employees, Representatives and Agents of the above. I AGREE NOT TO SUE nor bring any type of lawsuit against any persons or entities mentioned above for any of the claims or liabilities that I have waived, released or discharged herein; and I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions.  I hereby affirm that I am eighteen (18) years of age or older and I have read this document and I understand its contents. I understand that I have given up substantial rights by signing this document and sign it voluntarily." subtype="text" class="form-control" name="i-acknowledge-that-soccer-or-any-sporting-event-is-an-extreme-test-of-a-persons-physical-and-mental-limits-and-carries-with-it-the-potential-for-death-serious-injury-or-property-loss-i-recognize-that-i-may-be-asked-to-practice-for-participate-in-and-travel-to-and-from-soccer-events-on-behalf-of-the-team-and-i-here-by-assume-the-risk-of-participation-in-the-soccer-event-waiver--liability-release-form-for-minors-only-i-am-under-the-age-of-eighteen-18-years-old-my-parentsguardian-has-read-and-completed-the-section-below-if-the-applicant-is-under-18-years-of-age-a-parent-or-guardian-must-execute-in-addition-to-the-foregoing-waiver-and-liability-release-the-following-for-and-on-behalf-of-the-minor-as-the-parent-and-natural-guardian-or-legal-guardian-of---minors-name-i-hereby-the-forgoing-waiver-and-liability-release-for-and-on-behalf-of-the-named-herein-i-hereby-bind-myself-the-minor-and-all-other-assigns-to-the-terms-of-the-waiver-and-liability-release-i-represent-that-i-have-legal-capacity-and-authority-to-act-for-and-on-behalf-of-the-minor-in-the-execution-of-the-waiver-and-liability-release-i-agree-that-prior-to-participating-i-will-inspect-the-facilities-and-equipment-to-be-used-and-if-i-believe-anything-is-unsafe-i-will-immediately-advise-the-coach-or-supervisor-of-such-conditions-and-refuse-to-participate-i-hereby-take-the-following-action-for-myself-my-executors-administrators-heirs-next-of-kin-successors-and-assigns-i-waive-release-and-discharge-from-any-and-all-claims-or-liabilities-for-death-or-personal-injury-or-damages-of-any-kind-which-arise-out-of-or-relate-to-my-participation-in-or-my-traveling-to-and-from-the-soccer-event-the-following-persons-or-entities-united-womens-soccer-uws-the-team-for-which-i-play-the-team-owner-any-sponsors-obtained-by-the-club-or-uws-any-players-or-coaches-any-officers-directors-employees-representatives-and-agents-of-the-above-i-agree-not-to-sue-nor-bring-any-type-of-lawsuit-against-any-persons-or-entities-mentioned-above-for-any-of-the-claims-or-liabilities-that-i-have-waived-released-or-discharged-herein-and-i-indemnify-and-hold-harmless-the-persons-or-entities-mentioned-above-from-any-claims-made-or-liabilities-assessed-against-them-as-a-result-of-my-actions--i-hereby-affirm-that-i-am-eighteen-18-years-of-age-or-older-and-i-have-read-this-document-and-i-understand-its-contents-i-understand-that-i-have-given-up-substantial-rights-by-signing-this-document-and-sign-it-voluntarily"></field>
		<field type="header" subtype="h3" label="UWS Waiver (for Minors ONLY)" class="header"></field>
		<field type="text" label="WAIVER &amp; LIABILITY RELEASE FORM (FOR MINORS ONLY): I AM UNDER THE AGE OF EIGHTEEN (18) YEARS OLD. MY PARENT(S)/GUARDIAN HAS READ AND COMPLETED THE SECTION BELOW. (If the applicant is under 18 years of age, a parent or guardian must execute, in addition to the foregoing Waiver and Liability Release, the following, for and on behalf of the minor.) As the parent and natural guardian or legal guardian of _________________________________________ (minor’s name) I hereby the forgoing Waiver and Liability Release for and on behalf of the named herein. I hereby bind myself, the minor and all other assigns to the terms of the Waiver and Liability Release. I represent that I have legal capacity and authority to act for and on behalf of the minor in the execution of the Waiver and Liability Release." subtype="text" class="form-control" name="waiver--liability-release-form-for-minors-only-i-am-under-the-age-of-eighteen-18-years-old-my-parentsguardian-has-read-and-completed-the-section-below-if-the-applicant-is-under-18-years-of-age-a-parent-or-guardian-must-execute-in-addition-to-the-foregoing-waiver-and-liability-release-the-following-for-and-on-behalf-of-the-minor-as-the-parent-and-natural-guardian-or-legal-guardian-of--minors-name-i-hereby-the-forgoing-waiver-and-liability-release-for-and-on-behalf-of-the-named-herein-i-hereby-bind-myself-the-minor-and-all-other-assigns-to-the-terms-of-the-waiver-and-liability-release-i-represent-that-i-have-legal-capacity-and-authority-to-act-for-and-on-behalf-of-the-minor-in-the-execution-of-the-waiver-and-liability-release"></field>
		<field type="header" subtype="h3" label="US Adult Soccer Waiver" class="header"></field>
		<field type="text" required="true" label="In consideration of being allowed to participate in any way for the United States Adult Soccer Association, Inc., Its Affiliates, Leagues, and Member Teams, its related events and activities, the undersigned, acknowledges, appreciates, and agrees that: 1) The risk of injury or illness from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or illness does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS OF INJURY OR ILLNESS, both known and unknown to me at the time of this agreement, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, 1 will bring such to the attention of the nearest official immediately; and 4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the United States Adult Soccer Association, Inc. Its Affiliates, Leagues and Member Teams, their officers, officials, agents and/or employees, other participants sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (&quot;Releasees&quot;), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT." subtype="text" class="form-control" name="in-consideration-of-being-allowed-to-participate-in-any-way-for-the-united-states-adult-soccer-association-inc-its-affiliates-leagues-and-member-teams-its-related-events-and-activities-the-undersigned-acknowledges-appreciates-and-agrees-that-1-the-risk-of-injury-or-illness-from-the-activities-involved-in-this-program-is-significant-including-the-potential-for-permanent-paralysis-and-death-and-while-particular-rules-equipment-and-personal-discipline-may-reduce-this-risk-the-risk-of-serious-injury-or-illness-does-exist-and-2-i-knowingly-and-freely-assume-all-such-risks-of-injury-or-illness-both-known-and-unknown-to-me-at-the-time-of-this-agreement-even-if-arising-from-the-negligence-of-the-releasees-or-others-and-assume-full-responsibility-for-my-participation-and-3-i-willingly-agree-to-comply-with-the-stated-and-customary-terms-and-conditions-for-participation-if-however-i-observe-any-unusual-significant-hazard-during-my-presence-or-participation-1-will-bring-such-to-the-attention-of-the-nearest-official-immediately-and-4-i-for-myself-and-on-behalf-of-my-heirs-assigns-personal-representatives-and-next-of-kin-hereby-release-indemnify-and-hold-harmless-the-united-states-adult-soccer-association-inc-its-affiliates-leagues-and-member-teams-their-officers-officials-agents-andor-employees-other-participants-sponsoring-agencies-sponsors-advertisers-and-if-applicable-owners-and-lessors-of-premises-used-to-conduct-the-event-releasees-with-respect-to-any-and-all-injury-disability-death-or-loss-or-damage-to-person-or-property-whether-arising-from-the-negligence-of-the-releasees-or-otherwise-to-the-fullest-extent-permitted-by-law-i-have-read-this-release-of-liability-and-assumption-of-risk-agreement-fully-understand-its-terms-understand-that-i-have-given-up-substantial-rights-by-signing-it-and-sign-it-freely-and-voluntarily-without-any-inducement"></field>
		<field type="header" subtype="h3" label="US Adult Soccer Waiver (for Minors ONLY)" class="header"></field>
		<field type="text" required="true" label="This is to certify that I, as parent/guardian with legal responsibility for this participant, do 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 liabilities incident 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." subtype="text" class="form-control" name="this-is-to-certify-that-i-as-parentguardian-with-legal-responsibility-for-this-participant-do-consent-and-agree-to-hisher-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-liabilities-incident-to-my-minor-childs-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"></field>
		<field type="checkbox" required="true" label="By checking this box I confirm my guardian or I have signed the participation waivers before completing this form and payment." class="checkbox" name="by-checking-this-box-i-confirm-my-guardian-or-i-have-signed-the-participation-waivers-before-completing-this-form-and-payment"></field>
		<field type="text" required="true" label="LAST NAME" subtype="text" class="form-control" name="last-name"></field>
		<field type="text" required="true" label="FIRST NAME" subtype="text" class="form-control" name="first-name"></field>
		<field type="text" required="true" label="MIDDLE NAME" subtype="text" class="form-control" name="middle-name"></field>
		<field type="text" required="true" label="DATE OF BIRTH" subtype="text" class="form-control" name="date-of-birth"></field>
		<field type="text" required="true" label="PHONE" subtype="text" class="form-control" name="phone-"></field>
		<field type="text" required="true" label="EMAIL" subtype="text" class="form-control" name="email"></field>
		<field type="text" required="true" label="ADDRESS" subtype="text" class="form-control" name="address"></field>
		<field type="text" required="true" label="CITY" subtype="text" class="form-control" name="city"></field>
		<field type="text" required="true" label="STATE" subtype="text" class="form-control" name="state"></field>
		<field type="text" required="true" label="ZIP CODE" subtype="text" class="form-control" name="zip-code"></field>
		<field type="text" required="true" label="PLACE OF BIRTH (CITY  STATE  COUNTRY)" subtype="text" class="form-control" name="place-of-birth-city-state-country"></field>
		<field type="text" required="true" label="PLACE OF CITIZENSHIP" subtype="text" class="form-control" name="place-of-citizenship"></field>
		<field type="select" required="true" label="Have you played professional soccer In the US or abroad?" class="form-control" name="have-you-played-professional-soccer-in-the-us-or-abroad">
			<option label="YES" value="yes">YES</option>
			<option label="NO" value="no">NO</option>
		</field>
		<field type="select" required="true" label="Have you EVER played soccer outside of the US at anytime in your life??" class="form-control" name="have-you-ever-played-soccer-outside-of-the-us-at-anytime-in-your-life">
			<option label="YES" value="yes">YES</option>
			<option label="NO" value="no" selected="true">NO</option>
		</field>
		<field type="textarea" label="If so  where?" class="form-control" name="if-so-where"></field>
		<field type="text" required="true" label="OCCUPATION" subtype="text" class="form-control" name="occupation"></field>
		<field type="select" required="true" label="JERSEY SIZE" class="form-control" name="jersey-size">
			<option label="ADULT SMALL" value="adult-small" selected="true">ADULT SMALL</option>
			<option label="ADULT MEDIUM" value="adult-medium">ADULT MEDIUM</option>
			<option label="ADULT LARGE" value="adult-large">ADULT LARGE</option>
			<option label="ADULT EXTRA LARGE" value="adult-extra-large">ADULT EXTRA LARGE</option>
		</field>
		<field type="select" required="true" label="SHORTS SIZE" class="form-control" name="shorts-size">
			<option label="ADULT SMALL" value="adult-small">ADULT SMALL</option>
			<option label="ADULT MEDIUM" value="adult-medium">ADULT MEDIUM</option>
			<option label="ADULT LARGE" value="adult-large">ADULT LARGE</option>
			<option label="ADULT EXTRA LARGE" value="adult-extra-large">ADULT EXTRA LARGE</option>
		</field>
		<field type="textarea" required="true" label="POSITIONS" class="form-control" name="positions"></field>
		<field type="textarea" required="true" label="PREVIOUS EXPERIENCE (Start with Club you last played with and league/level)" class="form-control" name="previous-experience-start-with-club-you-last-played-with-and-leaguelevel"></field>
		<field type="textarea" required="true" label="PREVIOUS EXPERIENCE (College)" class="form-control" name="previous-experience-1685009556448"></field>
		<field type="textarea" required="true" label="College and Grad Year" class="form-control" name="college-and-grad-year"></field>
		<field type="textarea" required="true" label="TOP 6 DESIRED JERSEY #'s" class="form-control" name="top-6-desired-jersey-s"></field>
		<field type="text" required="true" label="EMERGENCY CONTACT FULL NAME" subtype="text" class="form-control" name="emergency-contact-full-name"></field>
		<field type="text" required="true" label="EMERGENCY CONTACT NUMBER" subtype="text" class="form-control" name="emergency-contact-number"></field>
		<field type="text" required="true" label="RELATIONSHIP TO EMERGENCY CONTACT" subtype="text" class="form-control" name="relationship-to-emergency-contact"></field>
		<field type="select" required="true" label="DOMINANT FOOT" class="form-control" name="dominant-foot">
			<option label="RIGHT" value="right" selected="true">RIGHT</option>
			<option label="LEFT" value="left">LEFT</option>
		</field>
	</fields>
</form-template>