Individual Player Registration

Monday Training - NSA Session 2

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 = Required Field

 

 
 
 
 
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  AGE GROUP ('18-'19) 
 
 
 Grade ('18-'19): 
 Emergency Contact 
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Comments 

 Approvals

I, the parent/guardian of the above named Registrant, in consideration of accepting the Registrant for their soccer and/or futsal programs and activities (collectively the “Programs”) and recognizing the risk of potentially significant physical injury occurring by participation in the Programs, including permanent disability or death, for myself and Registrant, do knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for the Registrants participation in the Programs. Further, I, for myself and Registrant, and on behalf of our respective heirs, assigns, personal representatives and next of kin, do hereby release, indemnify and hold harmless Brazilian Art Soccer Training, FutsalNH, its affiliated organizations and sponsors, and each of their employees, volunteers, agents, other participants, hosts, sponsors, advertisers, and the owners of the premises upon which the Programs are held (collectively, the "Releases"), with respect to any and all injury, disability, death, or loss or damage to person or property incident to Registrants participation in the Programs, and/or being transported to or from the same, which transportation I hereby authorize, and whether arising from the negligence of the Releases or otherwise, to the fullest extent permitted by law. I hereby warrant and represent that the Registrant has received a physical examination by a physician and has been found physically capable of participating in the Programs with no reservations or restrictions. I, for myself and Registrant, do hereby consent to have a doctor of medicine or dentistry, a licensed nurse or emergency technician provide Registrant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. 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
I, the parent/guardian of the above named Registrant, in consideration for accepting the Registrant for their Soccer and/or Futsal programs and activities (collectively the “Programs”) hereby grants to FutsalNH 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.

I understand that in addition to the league fees, each player must register with United States Youth Futsal (USYF). The $13.50 per player fee and player releases are completed and paid online by the player/parent/guardian (P/P/G). Players will not be eligible to participate unless payment is received and released authorized. Outdoor player registrations issued from US Club, AYSO, USYSA, State Associations. etc. are not valid for registration with USYF.

CRITICAL NOTICE: Double-check the name of the player and the date of birth (DOB) above to confirm they are input correctly or the USYF registration will not be valid. Also, if the player has already registered and paid the USYF player registration fee in the current year (8/1/2018– 7/31/2019), to avoid having to pay again, you must enter the player information exactly as it was input the first time the player was input and paid for the current year. Changing the player name or DOB from the previous registration will cause the system to recognize the player as a new player and will charge the fee again.


 CONTACT INFORMATION

GUARDIAN #1

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

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

 Refund Policy

Thank you for registering for the Futsal Winter Training.  You may cancel your registration before the registration deadline and receive a refund of your fees minus a $50 administrative fee. 

 Contact Info