Waiver Form — NextGen Soccer Camp 2026

Participant Information

Participant Full Name *

Date of Birth *

Age

Gender

Parent / Guardian Name *

Relationship to Participant *

Primary Phone Number *

Secondary Phone Number

Email Address *

Home Address *

City / State / ZIP *

Emergency Contact Information

Emergency Contact Name *

Relationship to Participant *

Emergency Contact Phone *

Alternate Emergency Contact

Alternate Contact Phone Number

Medical & Allergy Information

Known Allergies (food, medication, insects, etc.)

Does the participant carry an EpiPen or inhaler? *

Yes No

If yes, please explain

Existing Medical Conditions

Current Medications

Past Injuries or Physical Limitations

Primary Physician Name

Physician Phone Number

Health Insurance Provider

Policy Number

Agreements & Authorizations

Participation & Assumption of Risk

I understand that participation in soccer and athletic activities involves certain risks, including but not limited to falls, collisions, injuries, dehydration, heat-related illnesses, and other unforeseen risks associated with physical activity. I voluntarily permit my child to participate in NextGen Soccer Camp activities.

Medical Treatment Authorization

I authorize NextGen Soccer Camp staff, coaches, and representatives to seek emergency medical treatment for my child if I cannot be reached immediately. I understand that I am responsible for any medical expenses incurred.

Code of Conduct

Participants are expected to demonstrate respectful behavior toward coaches, staff, teammates, and camp property. Bullying, aggressive behavior, inappropriate language, or unsafe conduct may result in dismissal from camp without refund.

Photo & Media Release

I grant permission for NextGen Soccer Camp to use photographs and videos of my child for promotional materials, social media, websites, and marketing purposes.

Release of Liability

I hereby release and hold harmless NextGen Soccer Camp, its owners, coaches, employees, volunteers, and affiliates from any and all claims, liabilities, damages, or expenses arising from participation in camp activities, except in cases of gross negligence or intentional misconduct.

Printed Full Name *

Signature (Type Full Name) *

Date *

Your waiver will be sent to [email protected].
A secure payment link will be emailed to you after we review both forms.

What Happens Next?

After we receive both your Registration Form and Waiver Form, we will send you a secure payment link within 1–2 business days. Your athlete's spot is confirmed upon receipt of payment.

Step 1 — Also Required

If you haven't already, complete the Camp Registration Form first.

← Registration Form