I grant permission for my child to participate in the LWSA / AJAX Premier program, tryouts, clinics, camps, and rentals. Further, I declare that my child is in good health. I hereby release and indemnify the Leszek Wrona's Soccer Academy and any affiliated organizations, sponsors, employees, and owners from any liability claim on behalf of the registrant.

In consideration of being allowed to participate in any way and/or enter upon, use and/or engage in sports activities by Leszek Wrona’s Soccer Academy, LLC, including participation in practices, events and/or other uses of the indoor facility at 541 North Main Street Bristol CT, and their athletic/sports programs and related events and activities, the undersigned:

1. Agrees to prior to participating he/she will inspect the facilities and equipment to be used, and if he/she believes anything is unsafe, he/she will immediately advise a representative of Leszek Wrona’s Soccer Academy, LLC, of such conditions and refuse to participate;

2. Acknowledge and fully understand that each participate will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further that there might be other risks not known to us or not reasonably foreseeable at the time;

3. Assume all the foregoing risks and accept personal responsibility for the damage following such injury, permanent disability or death;

4. Release, waive, discharge and covenant not to sue Leszek Wrona’s Soccer Academy, LLC, or its affiliated clubs, it’s respective members, administrators, directors, coaches, and other employees of said organization, participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessees of the premises used to conduct the event, all of which are hereinafter referred to as “releases”, from demand, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise;

5. Shall defend, indemnify and hold Leszek Wrona’s Soccer Academy, LLC, its officers, employees, and agents harmless from and against any and all liability, loss, expense, including reasonable attorney fees, or claims for injury or damages arising out of the performance of this Agreement but only in proportion to and to the extent such liability, loss, expense, attorney fees, or claims for injury or damages caused by or result from the negligent or intentional acts or omissions of the individual or group renting space from the facility, its officers, agents or employees.

THE UNDERSIGNED HAVE READ AND ACKNOWLEDGED THAT HE/SHE IS ENTERING THE ABOVE WAIVER AND RELEASE, UNDERSTANDING THAT THEY HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY, WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, IT IS MY INTENTION ON BEHALF OF MYSELF OR MY MINOR CHILD TO SPECIFICALLY RELEASE AND INDEMNIFY LESZEK WRONA’S SOCCER ACADEMY, LLC, FROM ANY AND ALL CLAIMS ARISING FROM THEIR OWN NEGLIGENCE. I AGREE TO INDEMNIFY, DEFEND, AND HOLD HARMLESS LESZEK WRONA’S SOCCER ACADEMY, LLC FROM ANY LIABILITIES, LOSSES, DAMAGES, SETTLEMENTS, CLAIMS, EXPENSES, AND COSTS ARISING FROM MY OR MY CHILDS PARTICIPATION IN THE DESCRIBED ACTIVITY, SAID INDEMNITY TO INCLUDE COURT COSTS AND REASONABLE ATTORNEY FEES.

- Please speak with your physician before starting this exercise program –
COMMUNICABLE DISEASE ASSUMPTION OF RISK, HOLD HARMLESS, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT In consideration of being allowed to participate in any way and/or enter upon, use and/or engage in sports activities by LESZEK WRONA’S SOCCER ACADEMY and AJAX PREMIER, including participation in practices, events and/or other uses of the indoor facility at 541 North Main Street Bristol, CT ( collectively referred to herein as the “Facility”), and their athletic/sports programs and related events and activities (collectively referred to herein as “Activities”), the undersigned acknowledges and agrees to the following, on my own behalf, on behalf of any minor accompanying me, and on behalf of my personal representative, heirs and next of kin, agents and principals:

1. The novel coronavirus, COVID-19, also known as “severe acute respiratory syndrome coronavirus 2 (“SARS-CoV-2”) has been declared a worldwide pandemic by governments and public health agencies. SARS-CoV-2, COVID-19 and/or any mutation or variation thereof (hereinafter “COVID-19) is extremely contagious. COVID-19 and other communicable, contagious and/or infectious diseases, and (collectively, “Disease”) can be spread by exposure to people or otherwise.
2. The unavoidable risk exists that I will become exposed to and/or infected with Disease, and could suffer resulting and/or related death, disability, illness, sickness, infection, disease, syndrome and/or other undesirable health condition, whether now known or unknown from Disease.
3. I am aware that my participation in the Activities and my presence at Facility may cause me to be near and/or in contact with people and/or things that could raise the risk to me and others of exposure to Disease.
4. I know the risks of exposure cannot be eliminated no matter the degree of care exercised by anyone affiliated with Facility or Activities. No amount of protective measures or devices can guarantee freedom from Disease. By being at Facility, including, without limitation, participating in Activities, I know I could suffer personal injuries, or become ill, temporarily disabled and/or die (collectively “Afflicted”) from Disease. I voluntarily assume these risks and accept sole responsibility that I may be exposed to and/or Afflicted by Disease by entering Facility or participating in Activities.
5. Knowing the foregoing risks, including the fact that there are unknown risks, I voluntarily choose to enter, and be at Facility and to assume these risks of my own free will. I will not seek to hold any Release as defined below responsible if I am Afflicted by Disease.
6. If I choose not to assume these risks, I will neither enter Facility nor participate in Activities, and by staying at Facility I affirm my continuing acceptance of all such risks.
7. I understand that being Afflicted by Disease may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Releasees as defined below.
8. HEALTH & SAFETY DECLARATION and CONTINUING OBLIGATION. I attest and certify that I do not have and have not tested positive for or suffered from any symptoms of COVID-19 infection including without limitation cough; shortness of breath or difficulty breathing; fever; chills; repeated shaking with chills; repeated shaking with chills; generalized muscle pain; headache; sore throat; new loss of sense of taste or smell; fatigue or other flu-like symptoms (collectively the “Symptoms”), or have been exposed to any person exhibiting such Symptoms or, traveled outside the United States or to a location known to harbor such disease, in the past thirty (30) days. I am not under any quarantine orders. By my signature hereto I also agree to immediately inform the Facility if I subsequently suffer such symptoms and to refrain from entering until I provide satisfactory medical clearance to the Facility and am granted further permission to enter, subject to the terms and conditions of this agreement.
9. PERSONAL PROTECTIVE EQUIPMENT AND DISTANCING. I will provide and use my own personal protective equipment and practice social distancing (current CDC guidance is at least 6 feet from others whenever possible) and follow all other hygiene and infection control methods, as prescribed by applicable authorities such as the United States Centers for Disease Control, state and local health officials, or otherwise in effect at this Facility, to help protect myself and others from Disease.
10. LEAVING IF ILL. If while at Facility I feel or experience any Symptoms I agree that I will immediately leave Facility to seek medical attention (or seek emergency medical attention at Facility) and that I promptly will notify Facility officials of same.
11. NOT RESTRICTED BY GOVERNMENT ORDERS OR PERSONAL PHYSICIAN. I represent and warrant that any attendance at Facility and participation in Activities is not restricted by the advice of my personal physician or any governmental or public health order or rule of any federal, state, county or other applicable authority, including any order or rule due to my age, condition, government or public health orders of isolation due to illness or quarantine due to my exposure to others who are, were or may have been sick, or for any other reason. If I believe this is to not be the case, I will either not enter, or will promptly depart, Facility.
12. KNOWING AND VOLUNTARY. I acknowledge that I am voluntarily participating in Activities and visiting the Facility with an express understanding regarding the coronavirus pandemic and the other dangers described above, and I hereby agree to accept and assume any and all risks associated therewith. I have made the judgment that the benefits of Facility outweigh the risks that I am assuming.
13. SEVERABILITY AND ENFORCEMENT. This Agreement is intended to be as broad and inclusive as is permitted by the laws of the Province or State in which Activities are conducted and if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I intend for this Agreement to apply any time I am present at any Facility during dates noted above.
14. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, WAIVER, DISCHARGE, INDEMNIFY, AND HOLD HARMLESS Leszek Wrona’s Soccer Academy and AJAX Premier , and their respective officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct any program, event, or activity (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any exposure to Disease that may result in ILLNESS, INJURY, DISABILITY OR DEATH I may suffer, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. . I understand and agree that this release includes claims based on the actions, omissions, or negligence of any RELEASEE whether Disease exposure occurs before, during, or after entry to Facility and/or participation in Activities at Facility.

By agreeing to be part of our program, you give permission to our organization to use your child’s image and likeness on our website and in other marketing materials for our organization.