WINNER STAYS ON FORM

ALL Winner Stays On participants 18 years of age and older must complete this form and agree to the waiver before participating. You only need to complete this form once.

First Name

Last Name

What is your current club / school?

What is your age?

What is your Instagram Handle (or phone number)?

BALANCE SOCCER WINNER STAYS ON PARTICIPANT WAIVER: By signing, I acknowledge that I have been invited to participate in a Balance Soccer hosted pickup game and am doing so free of charge as a guest of Balance Soccer. I understand that soccer involves inherent physical risk and voluntarily assume full responsibility for my own safety. I release Balance Soccer, its owner, staff, and agents from any liability for injuries or damages arising from my participation, including those caused by negligence, field conditions, or provided equipment. I also grant Balance Soccer permission to use photos or video of me for promotional purposes without compensation, and I agree to arrive on time — repeated tardiness will result in removal from the program. This waiver is governed by the laws of the State of Oregon.

Participant Signature

Signed Date required

Thank You!

All game details will be shared via Instagram @balancesoccer

Talk to you soon.