Please contact the club administrator if you need to make alternate payment arrangements.
I, the parent/guardian of the below-named player, a minor, agree that I and the player will abide by the rules and regulations of the USYSA, its affiliated organizations and its sponsors (“USYSA Parties”). In consideration of the player’s participation in the soccer programs and activities of the USYSA Parties (“the Programs”), I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the USYSA Parties, the owner and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player’s participation in the Programs including, without limitation, player’s transportation to/from any Program, which transportation is authorized. I further grant the USYSA Parties the right to use the player’s name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player’s status as a participant in the Programs.
As the parent or legal guardian of the above named player, I hereby give consent for emergency Medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.
I understand there are NO REFUNDS and that I agree to all the charges as listed in this registration.
I understand that there are NO DOGS allowed during games or practices. I also understand that NON-COMPLIANCE may result in forfeiture of the game.
I agree to show an original Birth Certificate upon request.
AGAIN, I UNDERSTAND THERE ARE NO REFUNDS AND THERE ARE NO DOGS ALLOWED DURING GAMES OR PRACTICES.