FOR SCOR MEMBERS
SCOR SURVEY FOR FALL 21
Indicates required field
Birthday Child's Name
Age on Birthday
Responsible Parent or Guardian Name
Responsible Parent or Guardian's Email
Responsible Parent or Guardian Cell Phone Number
Number of Participants (including Birthday Child)
I Agree to the following:
A $50.00 non-refundable deposit is required to reserve the party date and time.
Party activities are 60 minutes in the gym unless otherwise agreed upon.
Party guests must be in proper workout attire.
GRATUITIES ARE NOT INCLUDED and should be considered if deserved.
Number of Instructors Needed
Total Payment Amount
$100 (10 Participants, 1 Coach or less)
$110 (11 Participants, 1 Coach)
$120 (12 Participants, 1 Coach)
$130 (13 Participants, 1 Coach)
$140 (14 Participants, 1 Coach)
$200 (15 Participants, 2 Coaches)
$210 (16 Participants, 2 Coaches)
$220 (17 Participants, 2 Coaches)
$230 (18 Participants, 2 Coaches)
$240 (19 Participants, 2 Coaches)
$250 (20 Participants, 2 Coaches)
$260 (21 Participants, 2 Coaches)
$300 (22-30 Participants, 2 Coaches)
$50.00 deposit which will be credited toward your full payment and will guarantee agreed upon services due at least 1 week prior to event. Checks can be made out to “Team Excel Soccer, LLC” and sent to 4 Sky Edge Lane, Bethel, CT 06801.
Full payment is due no later than the day and time after the event.
Cancellations & Refund Policy:
Cancellations must be made at least 3 days prior to event. Unfortunately, because of administrative and material costs deposit will NOT be reimbursed if cancellations are made after three days.
Hold Harmless Release Clause:
I, the applicant of the above “birthday party”, hereby assume all risk and hazards incidental to participation in all activities during said birthday party. Upon pressing ‘Submit’ I hereby waive, release, absolve, indemnify and agree to hold harmless Team Excel Soccer, LLC, Phil Bergen, Sr., coaches and participants from any claim arising out of injury.