OLYMPIA LIABILITY / COVID WAIVER

Welcome to the online Liability / COVID waiver form for OLYMPIA.
 
ALL players playing in a league or tournament that is run by a Karidis Group International company (Juventus Academy Saint Louis, Olympia, or PAO Volleyball) or renting training space at Olympia will need to complete this Liability / COVID waiver.
 - Leagues / Tournaments will need to complete a new form for each tournament and/or League played
- Training Rentals will need to submit the waiver once each season the rental is booked.

If you have any questions, please contact us at...
 
Chris Tiger | League & Tournament Director
E-Mail: tournaments@juventusacademystl.com
Phone: (636) 429-1908
 
Sasa Vasiljevic | Olympia General Manager
E-Mail: info@olympiaathletic.com
Phone: (636) 329-4949

Thank You For Your Support

PARTICIPANT INFORMATION

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PARTICIPANT GENDER *
NAME OF EVENT *
 
PARTICIPANT SPORT *

PARTICIPANT MEDICAL INFORMATION

PARENT/LEGAL GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION

COVID AGREEMENT

COVID PROTOCOL AGREEMENT *
HEALTH CONFIRMATION *
PLAYER COVID19 RESTRICTIONS *
SPECTATOR RESTRICTIONS *
POSSIBLE COVID19 EXPOSURE AGREEMENT *

LIABILITY / WAIVER RELEASE AGREEMENT

By signing below, I agree to the medical and waiver release agreement. I the undersigned (if applicant/participant is 18 years of age or older) or parent/guardian of the above listed minor applicant/participant acknowledge that I have been advised of the risks involved in my son’s/daughter’s participation at Olympia Athletic Centre and have been made aware that his/her participation may result in injury or harm to my son/daughter and I assume responsibility for any and all such risk to my son/daughter. In the event that my son/daughter may sustain an injury as a result of their participation, I hereby agree to hold harmless; Karidis Group International, Olympia Athletic Centre, Juventus Football Club, Juventus Academy Saint Louis, it’s directors, officers, coaches, athletic trainers, supervisors, and any other employees or agents there of including those who transport them to/from tryouts, practices, and games, for any and all such injuries. I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide my son/daughter with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I hereby authorize emergency transportation of my son/daughter to a medical treatment facility should an individual listed previously deem warranted. I affirmatively certify that to the best of my knowledge, my son/daughter is in good mental and physical health and capable of participating in this activity. I have read and fully understand the contents of this “hold harmless” agreement and execute same voluntary. If requested by Karidis Group International, Olympia Athletic Centre, Juventus Football Club, or Juventus Academy Saint Louis staff, I agree to modify his/her activities as directed. I further give my permission for the free use of the participants name and image/video in broadcast, telecast, or any other media account of any and all event/activities and for the promotional purposes of the Karidis Group International, Olympia Athletic Centre, Juventus Football Club, or Juventus Academy Saint Louis. I also understand that my personal information will not be sold to any outside party and will only be used for contact and or marketing for the following; Karidis Group International, Olympia Athletic Centre, Juventus Football Club, and Juventus Academy Saint Louis. 

COVID19 ADDITION:

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participation and attending games as a spectator; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Olympia may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Juventus FC, Juventus Academy Saint Louis, and Olympia, as well as their employees, volunteers, and program participants and their families.                 

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself and my child (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation at training/games at Olympia. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless Juventus FC, Juventus Academy Saint Louis, Karidis Group International, and Olympia, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Juventus FC, Juventus Academy Saint Louis, Karidis Group International, and Olympia, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation at Olympia.

I, THE UNDERSIGNED BELOW; UNDERSTAND & AGREE TO THE ABOVE LIABILITY/COVID19 RELEASE FORM. *
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PARENT / LEGAL GUARDIAN SIGNATURE *
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