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* 1. YOUR NAME

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* 2. ADDRESS

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* 3. LIST ANY CHILDREN YOU WILL BE SUPERVISING TONIGHT

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* 4. PLEASE CAREFULLY READ THE WAIVER & RELEASE OF LIABILITY

By my digital/virtual signature below, I confirm my understanding of the following concerning my voluntary participation in today’s event.  I choose to participate in this activity at my own risk and I will abide by any and all instructions provided to participants to help assure my own safety and that of my participating family members, if applicable.  I agree to assume all risks associated with my participation in this activity and I indemnify and hold harmless the River Parks Authority, the City of Tulsa, Tulsa County, WSA Soccer, Tulsa Field Sports Alliance, and their respective officers, directors, employees, contractors, volunteers,  and/or agents for any claims for personal injury or property damage resulting from or in any way connected with my participation in today’s activity.

I have read and understand and accept the terms and conditions outlined above on my behalf and on behalf of my entire party and any children I am supervising during the event.

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* 5. BY TYPING YOUR NAME BELOW YOU OFFER YOUR DIGITAL SIGNATURE AS AN UNDERSTANDING OF THESE TERMS FOR YOUR PARTICIPATION (and your children's participation under your supervision). 

COVID19 QUESTIONS

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* 6. TODAY'S DATE & TIME

Date
Time

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* 7. COVID Q1: Are you experiencing symptoms consistent with COVID-19 including fever of 100.4 degrees or higher or chills, persistent cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, nausea or vomitting, diarrhea, or loss of taste/smell?

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* 8. COVID Q2: Without social distancing or wearing a mask, have you been within six feet of a sick person with COVID-19 for 15 minutes or more in the past 14 days and/or are you actively caring for a person sick with COVID19?

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