SOCCER IN STEINER RANCH - Fall 2016 REGISTRATION
SOCCER IN STEINER RANCH - Fall 2016 REGISTRATION All games in Steiner Ranch Soccer age brackets (based on player age as of Sept. 1, 2016): 3v3 Divisions, Co-ed: Fours 4yr olds, Fives 5yr olds, Sixes 6yr olds 4v4 Divisions, Boys & Girls: 7 Boys, 7 Girls, 8-9 Boys, 8-9 Girls, 10-12 Boys, 10-12 Girls Regular Registration ends Aug, 14, 2016 or when a division becomes full; whichever comes first. Pre-Season Tournament: TBA Regular Season: Saturdays, September 17, 2016 – October 29, 2016 th 7 week is FALL 2016 World Cup XVI Tournament Practice: 1 weekly practice. (Coach picks Day/ Time/Field) most practices Steiner What You Get: Includes complete uniform of City, Club or International Replica Jersey with matching shorts and socks, Season Games, Neighborhood Tournament, Trophy, Painted Fields, and Referee’s. NFL Flag Football Now Includes Game Shorts Also! Register on-line at WWW.NSPORTS.US, By Mail – Complete registration form & payment to: Neighborhood Sports Program @ 2000 Windy Terrace. Suite 7B, Cedar Park, TX 78613 By Fax: 512-257-3524 ***For more information call us at 512-918-3524 Play both, Soccer & NFL Youth Flag Football for only $260, a savings of $20! Now ages 7 and up can play both on the same weekend. Neighborhood Sports Soccer and NFL Flag Football age bracket game schedules will not conflict. Coaching at Neighborhood Sports is fun and rewarding. Head Coaches receive a registration fee discount and training. Registration : Sport (circle one or both): Soccer NFL Youth Flag Football Fee $125 Discount Fee for Volunteer Head Coach’s child - Soccer $145 Soccer Player Registration $240 Discount Fee for Dual Volunteer Head Coach’s child – Coach Soccer & Flag Football (Ages 7 and up only) $250 Discount fee for dual sport player soccer volunteer head coach child - Coach soccer (Ages 7 and up only) $260 Dual Sport Player Registration – Play both Soccer & NFL Flag Football for one low fee (Ages 7 and up only) $20 Late Fee - Additional $20 on all registrations after August, 2016 (if space is available) $_______ your donation I’m going to help kids who can’t afford to play…play (Here is my donation) Players Name:
Parents Name:
Emergency phone:
Home phone:
Address:
Player Age on 9-1-2016:
City
Player Birth Date:
Email:
Male / Female (circle one)
# of Seasons Played:
ONLY Head coach's child receives discount Head Coach Volunteer Shirt size (AS, AM, AL, AXL)
Zip
Neighborhood You Live In: Grade / School:
Only 1 coach or 1 friend request allowed:
(Circle one) Head Coach Assistant Coach Team Parent Coach’s clinic will be provided. Head coach bringing multiple players must have entire expected roster register individually by July21, 2016.
Code of Conduct and Sportsmanship Policy _____ Parent Initials
I have read the Code of Conduct and Sportsmanship Policy as posted under “Forms” on the www.neighborhoodsports.us website and understand that any violations may result in disciplinary action that could include, but is not limited to the following: verbal warning by official, Neighborhood Sports Director; ejection from field/gym; parental game suspension, game forfeit; or season suspension with no refund of fees.
Parents/Legal Guardian _____
I have read the Authorization to use Name, Likeness and Voice along with the Parent Release/Waiver (see page 2). Please initial, sign and submit attached (page 2) Participant Authorization to use Name, Likeness and Voice along with Parent Release/Waiver.
Parent Initials
Parent/Legal Guardian Signature: ____________________________________________Date: ______________ Paid by: Check# _______ Cash: ______
($4.00 processing fee will be charged for Credit Card Payment)
Credit Card: _______________________________________Exp.Date________
Participant Authorization to use Name, Likeness and Voice In consideration for being allowed to participate in the Neighborhood Sports NFL Flag football games and other related events and activities (individually and collectively, ”The Event”), I hereby authorize, license, permit and grant to I.M.T.A.G. LLC and Neighborhood Sports, assigns, successors, sponsors, sponsoring agencies, advertisers, and owners or lessors of premises used in connection with the Event, and their respective officers, directors, partners, members, shareholders, employees, agents, independent contractors and representatives (collectively, the “Authorized Parties”), the right to use, reproduce, print, publish or disseminate in all manners and media now known or subsequently developed, in all social media, broadcast, promotion, advertising, information, press releases and press conferences or announcements for the Event or other Neighborhood Sports programs or events, my name, likeness and voice. I understand the Authorized Parties have no obligation to use my rights of publicity in any materials. I, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise (Including from the Authorized Parties’ use of my rights of publicity), to the fullest extent permitted by law. I HAVE READ THE ABOVE AUTHORIZATION, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THE RIGHTS THAT I HAVE GRANTED BY SIGNING BELOW. I SIGN THIS AUTHORIZATION FREELY AND VOLUNTARILY, WITHOUT ANY INDUECMENT OR COERCION _____________________________________ Participant Name
______________________ Date of Birth
Parent Release/Waiver In return for my child (*Participant) being allowed to participate in the Neighborhood Sports program (Program), I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates from all present and future claims that may be made by the Participant or me, my family, estate, heirs or assigns for property damage, personal injury or wrongful death arising as a result of the Participant’s participation in the Program and caused by the ordinary negligence of the parties listed above, wherever, whenever, or however the same may occur. I understand and agree that those listed above are not responsible for any injury or property damage arising out of the Program, even if cause by their ordinary negligence. I understand that participation in the Program involves certain risks, including, but not limited to, serious injury. I am voluntarily allowing Participant to participate in the Program with knowledge of the danger involved and agree to accept all risks of such participation. I certify that the Participant is in excellent physical health and may participate in strenuous and hazardous physical activities, including football, kickball, basketball, and all other activities to be played in the Program. Permission is granted for Participant to receive emergency medical treatment, if needed. I also agree to indemnify and hold harmless those listed above for all claims arising out of Participant’s participation in the Program and all related activities. I agree to let the parties use Participant’s name and likeness free of charge in any manner and for any purpose without compensation to Participant or me. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Program is taking place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in Austin, Texas. I am of legal age and am freely signing this Agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I represent that I am parent/ legal guardian of the child named above, and I agree that the terms of this release are binding on the child and me. I understand that It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates have the right to remove participants, family, friends or anyone attending an event from games, the league or programs with or without cause and I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, or their affiliates. Parent/Guardian of Participant This is to certify that I, _________________________________________(please print name), as the parent/guardian with legal responsibility for the above named Participant, consent and agree to the above authorization and, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise, to the fullest extent permitted by law. _____________________________________________ Parent/Guardian Signature
__________________ Date Signed
______________________________________________________________________ Home Address (Please Print)
_______________________________ Phone
______________________________________________________________________Email Address
Parents Name:
Emergency phone:
Home phone:
Address:
Player Age on 9-1-2016:
City
Player Birth Date:
Email:
Male / Female (circle one)
# of Seasons Played:
ONLY Head coach's child receives discount Head Coach Volunteer Shirt size (AS, AM, AL, AXL)
Zip
Neighborhood You Live In: Grade / School:
Only 1 coach or 1 friend request allowed:
(Circle one) Head Coach Assistant Coach Team Parent Coach’s clinic will be provided. Head coach bringing multiple players must have entire expected roster register individually by July21, 2016.
Code of Conduct and Sportsmanship Policy _____ Parent Initials
I have read the Code of Conduct and Sportsmanship Policy as posted under “Forms” on the www.neighborhoodsports.us website and understand that any violations may result in disciplinary action that could include, but is not limited to the following: verbal warning by official, Neighborhood Sports Director; ejection from field/gym; parental game suspension, game forfeit; or season suspension with no refund of fees.
Parents/Legal Guardian _____
I have read the Authorization to use Name, Likeness and Voice along with the Parent Release/Waiver (see page 2). Please initial, sign and submit attached (page 2) Participant Authorization to use Name, Likeness and Voice along with Parent Release/Waiver.
Parent Initials
Parent/Legal Guardian Signature: ____________________________________________Date: ______________ Paid by: Check# _______ Cash: ______
($4.00 processing fee will be charged for Credit Card Payment)
Credit Card: _______________________________________Exp.Date________
Participant Authorization to use Name, Likeness and Voice In consideration for being allowed to participate in the Neighborhood Sports NFL Flag football games and other related events and activities (individually and collectively, ”The Event”), I hereby authorize, license, permit and grant to I.M.T.A.G. LLC and Neighborhood Sports, assigns, successors, sponsors, sponsoring agencies, advertisers, and owners or lessors of premises used in connection with the Event, and their respective officers, directors, partners, members, shareholders, employees, agents, independent contractors and representatives (collectively, the “Authorized Parties”), the right to use, reproduce, print, publish or disseminate in all manners and media now known or subsequently developed, in all social media, broadcast, promotion, advertising, information, press releases and press conferences or announcements for the Event or other Neighborhood Sports programs or events, my name, likeness and voice. I understand the Authorized Parties have no obligation to use my rights of publicity in any materials. I, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise (Including from the Authorized Parties’ use of my rights of publicity), to the fullest extent permitted by law. I HAVE READ THE ABOVE AUTHORIZATION, FULLY UNDERSTAND ITS TERMS AND UNDERSTAND THE RIGHTS THAT I HAVE GRANTED BY SIGNING BELOW. I SIGN THIS AUTHORIZATION FREELY AND VOLUNTARILY, WITHOUT ANY INDUECMENT OR COERCION _____________________________________ Participant Name
______________________ Date of Birth
Parent Release/Waiver In return for my child (*Participant) being allowed to participate in the Neighborhood Sports program (Program), I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates from all present and future claims that may be made by the Participant or me, my family, estate, heirs or assigns for property damage, personal injury or wrongful death arising as a result of the Participant’s participation in the Program and caused by the ordinary negligence of the parties listed above, wherever, whenever, or however the same may occur. I understand and agree that those listed above are not responsible for any injury or property damage arising out of the Program, even if cause by their ordinary negligence. I understand that participation in the Program involves certain risks, including, but not limited to, serious injury. I am voluntarily allowing Participant to participate in the Program with knowledge of the danger involved and agree to accept all risks of such participation. I certify that the Participant is in excellent physical health and may participate in strenuous and hazardous physical activities, including football, kickball, basketball, and all other activities to be played in the Program. Permission is granted for Participant to receive emergency medical treatment, if needed. I also agree to indemnify and hold harmless those listed above for all claims arising out of Participant’s participation in the Program and all related activities. I agree to let the parties use Participant’s name and likeness free of charge in any manner and for any purpose without compensation to Participant or me. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the Program is taking place and agree that if any portion of this Agreement is invalid, the remainder will continue in full legal force and effect. I further agree that any legal proceedings related to this waiver will take place in Austin, Texas. I am of legal age and am freely signing this Agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I represent that I am parent/ legal guardian of the child named above, and I agree that the terms of this release are binding on the child and me. I understand that It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, and affiliates have the right to remove participants, family, friends or anyone attending an event from games, the league or programs with or without cause and I release and agree not to sue It’s More Than a Game Inc., Neighborhood Sports, their employees, sub-contractors, volunteers, sponsors, or their affiliates. Parent/Guardian of Participant This is to certify that I, _________________________________________(please print name), as the parent/guardian with legal responsibility for the above named Participant, consent and agree to the above authorization and, for myself and on behalf of my heirs, assigns and next of kin, hereby release, indemnify and hold harmless the Authorized Parties with respect to any and all injury, loss or damage, arising out of this authorization, whether from the negligence of any or all of the Authorized Parties or otherwise, to the fullest extent permitted by law. _____________________________________________ Parent/Guardian Signature
__________________ Date Signed
______________________________________________________________________ Home Address (Please Print)
_______________________________ Phone
______________________________________________________________________Email Address
