KLDU YOUTH SOCCER
Consent, Waiver & Medical Authorization
Winter 2026 Season · One form per player · Must be signed by a parent or legal guardian
Player Information
| Player full name | Date of birth |
| Program (Tots / Juniors / Seniors) | Sessions per week (1× / 2×) |
| Parent / guardian name | Relationship to player |
| Phone | |
| Home address | |
Emergency Contact
| Name | Relationship | Phone |
Medical Information
List all allergies, medical conditions, medications and physical limitations the coaching staff must know about. Write "None" if there are none.
A. Consent to Participate
I give permission for my child to participate in KLDU Youth Soccer training programs, including team training, private training, camps and PA day programs. I confirm my child is in adequate health to take part in physical activity, and that I have disclosed all relevant medical information above. I have read the KLDU Club Policy & Code of Conduct and agree that my child and our family will follow it.
B. Assumption of Risk & Waiver of Liability
I understand that soccer is a physical sport that carries inherent risks, including but not limited to sprains, strains, fractures, collisions with other players, concussion and other injury. I accept these risks on behalf of my child.
To the extent permitted by law, I release KLDU Youth Soccer (K-Little Devils United), its coaches, staff, volunteers and facility partners from liability for injury, loss or damage arising from ordinary participation in club activities, except where caused by gross negligence or wilful misconduct. This does not limit any right that cannot be waived under the laws of Ontario.
C. Medical Treatment Authorization
In the event of injury or illness during a club activity, I authorize KLDU staff to administer basic first aid and, if I cannot be reached, to arrange emergency medical transport and treatment for my child. I accept responsibility for any costs not covered by provincial health insurance.
D. Photography & Media Consent
KLDU may photograph or record sessions for coaching review and club promotion, including the website and social media. Please choose one:
Signature
By signing below I confirm that I am the parent or legal guardian of the player named above, that I have read and understood sections A through D, and that I sign this document freely.
| Parent / guardian signature | Date | |
| Print name | Player name |
Return the completed form to klittledevilsunited@gmail.com or hand it to a coach at the first session. Questions: (647) 300-8548. Version: Winter 2026.