ONTARIO SOCCER ASSOCIATION

WAIVER AND RELEASE OF LIABILITY – REFEREES

(To be signed by Referees 18 yrs of age and older)

By signing this form you give up important legal rights. Please read carefully!

1. This is a binding legal agreement. As a Referee in the programs, activities and events of the Ontario Soccer Association

and its Districts, Leagues and Clubs, the undersigned acknowledges and agrees to the following terms:

Disclaimer

2. The Ontario Soccer Association, its Districts, Leagues and Clubs and their respective directors, officers, members,

employees, coaches, volunteers, officials, participants, clubs, agents, sponsors, owners/operators of facilities, and

representatives (the “Organization”) are not responsible for any accidental or unintentional injury, damage or loss of any kind

suffered by a Referee during, or as a result of, any program, activity or event of the Organization and caused by the risks

described in paragraph 3. This disclaimer will not include intentional acts of the Organization to any injury, loss or damage

suffered by a Referee during, or as a result of, any program, activity or event of the Organization.

Description of Risks

3. In consideration of my participation as a Referee in the programs, activities and events of the Organization, I hereby

acknowledge that I am aware of the risks and hazards associated with or related to refereeing soccer. The risks and hazards

of refereeing soccer include, but are not limited to injuries from:

a) Grass, turf and other surfaces including bacterial infections and rashes;

b) Falling to the ground due to uneven or irregular terrain or surfaces;

c) Collisions with walls, soccer equipment and soccer goals;

d) Failing to properly use any piece of equipment or from the mechanical failure of any piece of equipment;

e) Extreme weather conditions which may result in heatstroke, sunstroke or hypothermia;

f) Accidental or unintentional contact, collision or accidentally being struck by other participants or equipment;

g) Vigorous physical exertion and strenuous cardiovascular workouts;

h) Exerting and stretching various muscle groups; and

i) Travel to and from competitive events and associated non-competitive events which are an integral part of the

Organization’s activities.

4. Furthermore, I am aware:

a) That injuries sustained in soccer refereeing can be severe;

b) That I may come into close contact with other participants, including the possibility of accidental contact;

c) That I may experience anxiety while refereeing during the programs, activities or events of the Organization;

d) That my risk of injury is reduced if I follow all rules adopted by the Organization; and

e) That my risk of injury increases as I become fatigued.

Release of Liability

5. In consideration of the Organization allowing me to participate as a Referee, I agree:

a) To assume all risks described herein and arising out of, associated with or related to refereeing;

b) To be solely responsible for any injury, loss or damage that I might sustain while refereeing for the risks described

herein; and

c) To release the Organization from liability for any and all claims, demands, actions and costs that might arise out of my

refereeing for the risks described herein, even though such risks, injuries, loss, damage, claims, demands, actions or

costs may have been caused by the negligence of the Organization.

Acknowledgement

6. I acknowledge that I have read this agreement, that I have executed this agreement voluntarily, and that this agreement is to

be binding upon myself, my heirs, executors, administrators and representatives.

_____________________________ __________________________ _____________________

Name of Referee Signature of Referee Date

Revised March 6, 2009