Adult Soccer Registration Form

Ridgefield Adult Pick-up Soccer

* Indicates required field

Participant's Name *

First

Last

Age of Participant *

Gender *

Email Address *

Cell Phone Number *

Program Fee *

Payment Options *

I have placed a $90 check in the mail I will bring $90 payment to first session I will pay $10 drop-in fee every time I participate I do not have to pay because I am a Veteran

Hold Harmless Release Clause:
AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY THE UNDERSIGNED HAVE READ THE WAIVER AND RELEASE, UNDERSTAND THAT THEY HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY. In consideration of being allowed to participate in any way in the 'Ridgefield Pick-up Adult Soccer' Program, the undersigned: 1. Agree that prior to participating, they each will inspect the facilities and equipment to be used, and if they believe anything is unsafe, they will immediately advise their supervisor of such condition(s) and refuse to participate; 2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time; 3. Assume all of the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death; 4. Release, waive, discharge and convenient not to sue Team Excel Soccer LLC, Ridgefield Parks and Recreation, their respective administrators, agents, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as 'releases', from demand, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the release of otherwise.

I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SUBMITTING THIS FORM.

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