Player Registration

Ultimate Striker Soccer Training Session Two

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 Player Information

 
 
 
 
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  AGE GROUP ('21-'22) 
 
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 Approvals

I approve of my child’s attendance at the PLD Sports Camp and certify that he/she is in good health and able to participate in program activities. I hereby authorize the directors of the PLD Sports Camp and their employees and/or volunteers to act for me according to their best judgment in any emergency requiring medical attention, including treatment by a physician. I hereby release PLD Sports and it's staff from responsibility or liability for injury while participating in the camp.

TBK BANK SPORTS COMPLEX WAIVER AND RELEASE FORM

This Waiver and Release Form is made as of the date written below by the individual (electronically) signing this form (“Participant”) and provided to The BettPlex, LLC, a Minnesota limited liability company (“BettPlex”). The entire TBK Bank Sports Complex is owned by BettPlex and is known as TBK Bank Sports Complex (the “Facilities”). BettPlex also owns the family entertainment center which operates under the name of High 5 Lanes & Games I hereby assume all of the risks of participating in all activities at any of these facilities, including by way of example but not limited to any risks that may arise from: negligence or carelessness on the part of the persons or entities being released, dangerous or defective equipment or property owned, maintained or controlled by them, or their possible liability without fault. I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which could affect my participation in this activity. I acknowledge that this Waiver and Release of Liability will be used by the event holders, sponsors and organizers of the activity in which I may participate and that it will govern my actions and responsibilities at said activity. In consideration of my use of facilities or services provided at TBK BANK SPORTS COMPLEX, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns as follows: (A)I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The BettPlex, LLC (known as TBK BANK SPORTS COMPLEX)(including High 5 Lanes & Games) and its directors, officers, employees, volunteers, representatives, agents and activity holders, sponsors, and volunteers; (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of my use of these facilities, whether caused by the negligence of Release or otherwise. I acknowledge that TBK BANK SPORTS COMPLEX and its members, managers, employees, agents and contractors (“Releasees”) are NOT responsible for the errors, omissions, acts or failures to act of any person or entity conducting a specific activity. I acknowledge that this activity may involve a test of physical and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to, those caused by facilities, temperature, weather, condition of participants, equipment, lack of hydration and actions of other people including, but not limited to, participants, volunteers, coaches, parents, officials, umpires, referees, monitors, spectators and sponsors of any activity. These risks are not only inherent to participants, but are also present for volunteers and parents. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during this activity. I understand while participating in this activity, I may be photographed. I agree to allow my photo or video of my likeness to be used for any legitimate purpose by TBK Bank Sports Complex its employees, agents and assigns. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL

PARENTAL CONSENT: I am the minor’s parent or guardian named above, and I understand the nature of the above-referenced activities. I believe the minor is qualified to participate in activities at TBK BANK SPORTS COMPLEX (including High 5 Lanes & Games) and verify that the minor has the appropriate experience and capabilities to participate in any activities. I hereby release, discharge, covenant not to sue and agree to defend and indemnify, save and hold harmless each of the Releasees from all liability, claims, demands, losses or damages on the minor’s account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise as provided above. Further, I agree that if, despite the release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the Releasees, I will defend, indemnify, save and hold harmless each of the Releasees from any litigation expenses, attorney fees, loss liability, damage or cost any Releasee may incur as the result of such claim.

Waiver of Liability Form; Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19: The novel coronavirus (“COVID-19”) has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. The BettPlex LLC (known as the TBK Bank Sports Complex) has put in place preventative measures to reduce the spread of COVID-19, as have their partner programs; however, cannot guarantee that you will not become infected with COVID-19. Further, attending any program or activity at the TBK Bank Sports Complex (including High 5 Lanes & Games and Level II Fitness) could increase your risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 while attending the TBK Bank Sports Complex and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the TBK Bank Sports Complex may result from the actions, omissions, or negligence of myself and others, including, but not limited to, TBK Bank Sport Complex employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at the TBK Bank Sports Complex or(“Claims”). On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless the TBK Bank Sports Complex, its partner programs, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the TBK Bank Sports Complex, its partners programs, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after attending any TBK Bank Sports Complex program or activity. PARENTAL CONSENT: I am the minor’s parent or guardian named in this registration and I understand the nature of the Waiver of Liability above and verify and consent to the minor attending the TBK Bank Sports Complex. On the minor’s behalf, I hereby release, covenant not to sue, discharge, and hold harmless the TBK Bank Sports Complex, its partner programs, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages,costs or expenses of any kind arising out of or relating thereto. On behalf of the minor, I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the TBK Bank Sports Complex, its partner programs, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after attending in any TBK Bank Sports Complex program or activity.  

 CONTACT INFORMATION

GUARDIAN #1

 
 STATE 
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 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 
GUARDIAN #2 (optional)

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 

 Refund Policy

PLD SPORTS CANCELLATIONS & REFUND POLICY

 

Only a participant and his or her parents have authority to request a refund. There is a 25% non-refundable cancellation fee for ALL cancellations made up to 10 days prior to the first session of the program. Within 10 days prior to the start, the program becomes nonrefundable. No refunds will be given after the start of the program. Full refunds (minus the convenience fee), due to injury/illness will be honored with a doctor’s note or hospital record of the injury/illness.

 

The simplest way to cancel a registration is to email pauldayrell@pldsports.org  with the participant name, event enrolled in and registration confirmation number. If a program is canceled, a full refund will be given.


 Contact Info