Coach/Volunteer Medical Release

I hereby request that Kroenke Sports & Entertainment (“KSE”) the Colorado Rapids (“Rapids”) and the Colorado Rapids Youth Soccer Club (“CRYSC”) allow me to participate in the Colorado Rapids Youth Soccer Club programming at Dick’s Sporting Goods Park or at other locations to be determined. I understand that programming may include, but is not limited to Leagues, Camps, Clinics, Academy, Events, Alliance Events, and Competitive Teams. The language of this waiver is also intended to cover all tryouts and open-play sessions related to the Colorado Rapids Youth Soccer Club.

In considerations of KSE and the Rapids allowing me to participate in the Colorado Rapids Youth Soccer Club programming, I agree not to sue and forever release, waive and discharge KSE Soccer, Inc. (CO) dba Colorado Rapids, Kroenke Stadium Services, Inc., Kroenke Sports & Entertainment, LLC; Major League Soccer (“MLS”), Colorado Rapids Youth Soccer Club and their respective employees, governors, affiliates, agents, partners, owners, members, parents, subsidiaries, representatives, officers, attorneys and players (hereinafter referred to collectively as “Releaseees” from any and all liability to me, my child and his or her personal representatives, assigns, heirs, children, dependents, spouse and relatives for any and all claims, causes of action, losses, judgments, liens, costs, demands or damages that are caused by or arise from any injury (including death) to his/her person or property regardless of the cause(s) of such injury. I assume all risks associated with my participation in and observation of the Colorado Rapids Youth Soccer Club.

I further grant KSE Soccer, Inc. (CO) dba, Colorado Rapids and the Colorado Rapids Youth Soccer Club, Kroenke Stadium Services, Inc.; Major League Soccer (“MLS”), and their respective successors and assign the perpetual worldwide and royalty-free rights to use my voice, photograph, and likeness in any media related to my performance in or observation of the club including, without limitation, a videotape recording of such programming without compensation to me, or my personal representatives, assigns, heirs, children, dependents, spouse and relatives.

I certify thatI am in good mental and physical condition. I understand the inherent risks associated with participation in the club, and I also understand the inherent risks of participating in the sport of soccer at this level on a grass, astro-turf and blacktop surface. I recognize the possibility of physical injury associated with soccer, and in consideration of above organizations discharge and otherwise indemnify the organizations, the affiliates and sponsors, their employees and associated personnel (whether paid or volunteer) as well as the owners of the fields and facilities utilized for the programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the programs.

I authorize the Colorado Rapids and the Colorado Rapids Youth Soccer Club (CRYSC) staff to seek medical treatment for the me as they deem necessary at local medical facilities. I understand that this authorization is given in advance of any specific diagnosis, treatment or hospital care, and that it is given to provide the Colorado Rapids and CRYSC staff authority to seek medical treatment as he/she judge’s necessary to the above-named Participant. I accept responsibility for payment of all services rendered; I authorize any medical facility that renders services to release medical information necessary for the processing of insurance claims; and I authorize the payment of insurance claims directly to the medical facility. I understand that whenever possible, the Colorado Rapids and CRYSC will make a good faith effort to contact an emergency contact before seeking treatment. If this is not possible, I understand that the Colorado Rapids and CRYSC staff will notify my designee as soon as possible of any and all diagnoses and treatments. I also hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve my life, limb, or well-being.