PLAYER INFORMATION

Gender *
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TRYOUT CONFIRMATION *

PARENT INFORMATION

LIABILITY 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 in Panathinaikos Athletic Club 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 Panathinaikos Athletic Club, PAO FC, Karidis Group International, LLC, Olympia Athletic Centre, LLC, any of 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 Panathinaikos Athletic Organization 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 in broadcast, telecast, or any other media account of any and all event/activities and for the promotional purposes of Panathinaikos Athletic Organization, PAO FC, Karidis Group International, LLC and Olympia Athletic Centre, LLC.

Liability Waiver & Release Agreement *
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Signature *
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