Parental Consent Form


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In consideration of being allowed to participate in anyway in the MPYSA athletic sports program, related events and activities, the undersign acknowledges, appreciates that;

1.) The risk of injury from activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist;

2.) I knowingly and freely assume all such risk, both known and unknown even if arising from negligence of the releasees or others, and assume full responsibility for my participation; and

3.) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence of participation I will remove myself from participation and bring such to the attention of the nearest youth league official immediately: and

4.) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless the Cabarrus County Parks & Recreation Department, Bethel and MPYSA. There officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”) with respect to any and all injury, disability, death or loss or damage to person or property, whether arising from negligence of the releasees or otherwise.

5.) I or a legal guardian or representative will be at all practices and games to oversee my child’s welfare and have the legal authority to authorize medical treatment if necessary.

6.) I understand that any misconduct on my child’s part, as well as myself, during practices or games can result in my child being removed from practice and or games. Furthermore that any conduct deemed inappropriate by MPYSA director(s) may result in my child being removed from participation in MPYSA events without refund.

This is to certify that I, a parent / guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and myself, my heirs, assigns, and next of kin. I release and agree to indemnify and hold harmless the releasees from any all liabilities incident to my minor child involvement or participation in these programs as provided above, even if arising from their negligence.


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