Lakeside Alumni and Friends Soccer Booster Club Fundraiser

Soccer Tournament

 

Player Roster and Release Form -Keep this form- You will need it for check in!

 

Team:                                                                             Division:                                  

We, the undersigned, jointly and severally, as players, release and discharge any of the designated officials of the 2010 Lakeside Alumni and Friends Soccer Tournament, Tucker Youth Soccer Association, GYSA affiliated leagues and their representatives, and USSA from any and all liability, claims or demands arising from participating in the 2010 Lakeside Alumni and Friends Soccer Tournament specifically to include any and all claims for personal injuries sustained while present or participating in said Tournament.

 

Player’s Name                       Birth Date      Signature                            Date

 

1.                                                                                                                                

 

2.                                                                                                                                

 

3.                                                                                                                                

 

4.                                                                                                                                

 

5.                                                                                                                                

 

6.                                                                                                                                

 

7.                                                                                                                                

 

8.                                                                                                                                

 

9.                                                                                                                                

 

10.                                                                                                                              

 

I hereby verify that the above information is true and correct.

 

 

Team Representative’s Signature:                                                                      Date: