Individual Player Registration

Winter 25, Fairfield Mini Kickers, Saturday

Option:  

Required  Price: $195.00
Description: Tiny Kickers, 11am - 11.30am Class
 = Required Field

 

 
 
 
 
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  AGE GROUP ('24-'25) 
Comments / Allergies 


 Approvals

In consideration of being allowed to participate in any way at a CT Sports Network LLC sports program and related events and activities, 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 coach or supervisor of such condition(s) and refuse to participate; 
2: Acknowledge and fully understand that each participant will be engaging in activities that involve risks 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 the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death; 
4: Release, waive, discharge and covenant not to sue CT Sports Network LLC, their respective administrators, directors, agents, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as “releasees”, from demands, 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 releasee or otherwise. The undersigned have read the above waiver and release, understand that they have given up substantial rights by signing it and sign in voluntarily.

I, the parent/guardian of the above named Registrant, in consideration for accepting the Registrant for their sports programs and activities (collectively the “Programs”) hereby grants to CT Sports Network LLC the right and permission, free from approval, review, or cost, to photograph, record, or otherwise capture the Registrant's likeness in participating in the programs for use in media, now or hereafter known, including, but not limited to pictures and video, to copyright the same in its own name, and which may be included in whole or in part for commercial or promotional use.

In consideration of being allowed to participate in any way in any program, event, or activity sponsored or authorized by CT Sports Network, LLC and/or any affiliated member, I the undersigned, acknowledge, appreciate, and agree that:
I am aware there are risks to me of exposure to, directly or indirectly, arising out of, contributed to, by, or resulting from an outbreak of any and all communicable diseases, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof. 
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE CT SOCCER NETWORK, LLC AND ITS AFFILIATED MEMBERS, and their respective officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct any program, event, or activity (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any ILLNESS, INJURY, DISABILITY OR DEATH I may suffer, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

 
FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for said participant and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
 
 

As Parents/legal guardians of youth participants, we agree that prior to participation in any CT Sports Network program we will review, with our children, the concussion awareness educational material, "Heads Up: Concussion in Youth Sports" available online at www.cdc.gov/headsup/index.html. We will also utilize the other free educational material found on the CDC website.  

For any participant aged over 18 years of age, I agree to view the concussion awareness information located at www.cdc.gov/headsup/index.htm


 CONTACT INFORMATION

GUARDIAN #1

 
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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

Thank you for registering with CT Sports Network.  Refunds, in the form of a credit, will only be given if a request is made two weeks before the first scheduled clinic, or if there is a medical issue that prevents you from playing (a doctor's note is required before the refund will be granted). No refunds shall be issued from two weeks before the clinic starts.

There is a 25% administration charge for all refunds given.

 Contact Info