WINTER RECREATIONAL LEAGUE SESSION II
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1 WINTER RECREATIONAL LEAGUE SESSION II REGISTRATION FORM 2018 PLAYER LAST NAME: PLAYER FIRST NAME: PLAYER BIRTHDAY: SHIRT SIZE: HOME PHONE: CELL PHONE: STREET: TOWN NJ ZIP CODE: DAD S NAME MOM S NAME Do you wish to volunteer to coach? (Circle One) Head Coach - Assistant Coach YES NO CURRENT MEMBER YES NO PROGRAM FEE $ 45 MEMBERS $70 NON-MEMBERS Acknowledgement of Risk & Waiver Release of All Claims I am, the parent and/or legal guardian of the minor, understanding both the minor and the inherent risks associated with participating in SOCCER, I believe the minor to be qualified to participate, in good health, and in proper physical condition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the release s from all liability claims, demands, losses, or damages on the minor s account caused or alleged to be caused in whole or in part by the negligence of the releases (employees, volunteers, board or otherwise), including negligent rescue operation and further agree that if, despite their release, I, the minor, or anyone on the minor s behalf make a claim against any of the releases from any litigation expenses, attorney fees, loss liability, damage, or cost may incure as the result of any such claim. I understand and acknowledge that there is a $10.00 processing fee for any program refund given. Printed Name of Guardian: Date Guardian s Signature:
2 LIGA RECREACIONAL DE FUTBOL DE INVIERNO 2018 SESION II APELLIDO DEL JUGADOR NOMBRE FECHA DE NACIMIENTO TALLA DE CAMISETA TELEFONO CELULAR DIRECCION CIUDAD NJ CODIGO POSTAL CORREO ELECTRONICO NOMBRE DEL PADRE NOMBRE DE LA MADRE ALGUNO DE LOS PADRES LE GUSTARIA SER DIRECTOR TECNICO / AYUDANTE DEL TECNICO VOLUNTARIO? SI NO MIEMBRO ACTIVO SI NO COSTO DE LA MEMBRESIA $45 MEMBERS $70 NON-MEMBERS Reconocimiento de Riesgos e indemnización de daños y perjuicios Yo soy, el padre y / o guardián legal del menor, y comprendo tanto al menor como los riesgos inherentes asociados con la participación en el fútbol, afirmo que el menor esta calificado, tienen buena salud, y buena condición física para participar en dicha actividad. Por este medio libero, descargo y me comprometo a no demandar, y estoy de acuerdo en guardar y mantener exonerados (libre de culpa) a los miembros aquí mencionados de toda indemnización de daños, perjuicios, demandas o pérdidas causadas por el menor o supuestamente ser en parte o en su totalidad negligencia de los exonerados (estos pueden ser pero no se limita a empleados, voluntarios o miembros de la junta directiva), incluyendo cualquier negligencia de algún programa de rescate. Asimismo, acepto que si, a pesar de la falta de su permiso/renuncia, yo, el menor, o alguien en nombre del menor de edad presentar una reclamación contra cualquiera de los exonerados estos serán liberados de cualquier gastos de litigio, honorarios del abogado, responsabilidad de la pérdida, daño o cualquier costo que puede incurrir como resultado de dicha reclamación. Yo entiendo que hay un precio de procesamiento de $10.00para un reembolso de la programa. Nombre del padre/guardián: Fecha Firma del padre/guardián:
3 SPRING BASKETBALL LEAGUE AGE 5-14 Co-Ed 3 age divisions: Little Ballerz (5-8), Elementary (9-11) and Middle School (12 to 14) PLAYER LAST NAME: PLAYER FIRST NAME: DOB: SCHOOL GRADE T-SHIRT HOME PHONE: CELL PHONE: STREET: TOWN NJ ZIP CODE: DAD S NAME MOM S NAME Do you wish to volunteer to coach? (Circle One) Head Coach - Assistant Coach YES NO CURRENT MEMBER YES NO PROGRAM FEE $ 50 MEMBERS $75 NON-MEMBERS Acknowledgement of Risk & Waiver Release of All Claims I am, the parent and/or legal guardian of the minor, understanding both the minor and the inherent risks associated with participating in BASKETBALL, I believe the minor to be qualified to participate, in good health, and in proper physical condition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the release s from all liability claims, demands, losses, or damages on the minor s account caused or alleged to be caused in whole or in part by the negligence of the releases (employees, volunteers, board or otherwise), including negligent rescue operation and further agree that if, despite their release, I, the minor, or anyone on the minor s behalf make a claim against any of the releases from any litigation expenses, attorney fees, loss liability, damage, or cost may incure as the result of any such claim. I understand and acknowledge that there is a $10.00 processing fee for any program refund given. Printed Name of Guardian: Date Guardian s Signature:
4 SPRING BASKETBALL LEAGUE AGE 5-14 Co-Ed 3 divisiones: Little Ballerz (5-8), Elementary (9-11) and Middle School (12 to 14) APELLIDO DEL JUGADOR NOMBRE T-SHIRT FECHA DE NACIMIENTO ESCUELA GRADO TELEFONO CELULAR DIRECCION CIUDAD NJ CODIGO POSTAL CORREO ELECTRONICO NOMBRE DEL PADRE NOMBRE DE LA MADRE ALGUNO DE LOS PADRES LE GUSTARIA SER DIRECTOR TECNICO / AYUDANTE DEL TECNICO VOLUNTARIO? SI NO MIEMBRO ACTIVO SI NO COSTO DE LA MEMBRESIA $50 MEMBERS $75 NON-MEMBERS Reconocimiento de Riesgos e indemnización de daños y perjuicios Yo soy, el padre y / o guardián legal del menor, y comprendo tanto al menor como los riesgos inherentes asociados con la participación en el BASKETBALL, afirmo que el menor esta calificado, tienen buena salud, y buena condición física para participar en dicha actividad. Por este medio libero, descargo y me comprometo a no demandar, y estoy de acuerdo en guardar y mantener exonerados (libre de culpa) a los miembros aquí mencionados de toda indemnización de daños, perjuicios, demandas o pérdidas causadas por el menor o supuestamente ser en parte o en su totalidad negligencia de los exonerados (estos pueden ser pero no se limita a empleados, voluntarios o miembros de la junta directiva), incluyendo cualquier negligencia de algún programa de rescate. Asimismo, acepto que si, a pesar de la falta de su permiso/renuncia, yo, el menor, o alguien en nombre del menor de edad presentar una reclamación contra cualquiera de los exonerados estos serán liberados de cualquier gastos de litigio, honorarios del abogado, responsabilidad de la pérdida, daño o cualquier costo que puede incurrir como resultado de dicha reclamación. Yo entiendo que hay un precio de procesamiento de $ 10.00para un reembolso de la programa. Nombre del padre/guardián: Fecha Firma del padre/guardián:
5 FREE BASKETBALL CLINICS 5-8 GRADES THURSDAYS: FEBRUARY 2,9,23, MARCH 2 PLAYER LAST NAME: PLAYER FIRST NAME: DOB: SCHOOL GRADE T-SHIRT HOME PHONE: CELL PHONE: STREET: TOWN NJ ZIP CODE: DAD S NAME MOM S NAME Acknowledgement of Risk & Waiver Release of All Claims I am, the parent and/or legal guardian of the minor, understanding both the minor and the inherent risks associated with participating in BASKETBALL, I believe the minor to be qualified to participate, in good health, and in proper physical condition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the release s from all liability claims, demands, losses, or damages on the minor s account caused or alleged to be caused in whole or in part by the negligence of the releases (employees, volunteers, board or otherwise), including negligent rescue operation and further agree that if, despite their release, I, the minor, or anyone on the minor s behalf make a claim against any of the releases from any litigation expenses, attorney fees, loss liability, damage, or cost may incure as the result of any such claim. I understand and acknowledge that there is a $10.00 processing fee for any program refund given. Printed Name of Guardian: Date Guardian s Signature:
6 Gratis academia de basketball 5-8 Grado JUEVES: FEBRERO 2,9,23, MARZO 2 APELLIDO DEL JUGADOR NOMBRE T-SHIRT FECHA DE NACIMIENTO ESCUELA GRADO TELEFONO CELULAR DIRECCION CIUDAD NJ CODIGO POSTAL CORREO ELECTRONICO NOMBRE DEL PADRE NOMBRE DE LA MADRE Reconocimiento de Riesgos e indemnización de daños y perjuicios Yo soy, el padre y / o guardián legal del menor, y comprendo tanto al menor como los riesgos inherentes asociados con la participación en el BASKETBALL, afirmo que el menor esta calificado, tienen buena salud, y buena condición física para participar en dicha actividad. Por este medio libero, descargo y me comprometo a no demandar, y estoy de acuerdo en guardar y mantener exonerados (libre de culpa) a los miembros aquí mencionados de toda indemnización de daños, perjuicios, demandas o pérdidas causadas por el menor o supuestamente ser en parte o en su totalidad negligencia de los exonerados (estos pueden ser pero no se limita a empleados, voluntarios o miembros de la junta directiva), incluyendo cualquier negligencia de algún programa de rescate. Asimismo, acepto que si, a pesar de la falta de su permiso/renuncia, yo, el menor, o alguien en nombre del menor de edad presentar una reclamación contra cualquiera de los exonerados estos serán liberados de cualquier gastos de litigio, honorarios del abogado, responsabilidad de la pérdida, daño o cualquier costo que puede incurrir como resultado de dicha reclamación. Yo entiendo que hay un precio de procesamiento de $ 10.00para un reembolso de la programa. Nombre del padre/guardián: Fecha Firma del padre/guardián:
7 PRESIDENTS DAY FREE CLINIC 1-4 GRADES PLAYER LAST NAME: PLAYER FIRST NAME: DOB: SCHOOL GRADE T-SHIRT HOME PHONE: CELL PHONE: STREET: TOWN NJ ZIP CODE: DAD S NAME MOM S NAME Acknowledgement of Risk & Waiver Release of All Claims I am, the parent and/or legal guardian of the minor, understanding both the minor and the inherent risks associated with participating in BASKETBALL, I believe the minor to be qualified to participate, in good health, and in proper physical condition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the release s from all liability claims, demands, losses, or damages on the minor s account caused or alleged to be caused in whole or in part by the negligence of the releases (employees, volunteers, board or otherwise), including negligent rescue operation and further agree that if, despite their release, I, the minor, or anyone on the minor s behalf make a claim against any of the releases from any litigation expenses, attorney fees, loss liability, damage, or cost may incure as the result of any such claim. I understand and acknowledge that there is a $10.00 processing fee for any program refund given. Printed Name of Guardian: Date Guardian s Signature:
8 PRESIDENT DAY FREE CLINIC 1-4 Grado APELLIDO DEL JUGADOR NOMBRE T-SHIRT FECHA DE NACIMIENTO ESCUELA GRADO TELEFONO CELULAR DIRECCION CIUDAD NJ CODIGO POSTAL CORREO ELECTRONICO NOMBRE DEL PADRE NOMBRE DE LA MADRE Reconocimiento de Riesgos e indemnización de daños y perjuicios Yo soy, el padre y / o guardián legal del menor, y comprendo tanto al menor como los riesgos inherentes asociados con la participación en el BASKETBALL, afirmo que el menor esta calificado, tienen buena salud, y buena condición física para participar en dicha actividad. Por este medio libero, descargo y me comprometo a no demandar, y estoy de acuerdo en guardar y mantener exonerados (libre de culpa) a los miembros aquí mencionados de toda indemnización de daños, perjuicios, demandas o pérdidas causadas por el menor o supuestamente ser en parte o en su totalidad negligencia de los exonerados (estos pueden ser pero no se limita a empleados, voluntarios o miembros de la junta directiva), incluyendo cualquier negligencia de algún programa de rescate. Asimismo, acepto que si, a pesar de la falta de su permiso/renuncia, yo, el menor, o alguien en nombre del menor de edad presentar una reclamación contra cualquiera de los exonerados estos serán liberados de cualquier gastos de litigio, honorarios del abogado, responsabilidad de la pérdida, daño o cualquier costo que puede incurrir como resultado de dicha reclamación. Yo entiendo que hay un precio de procesamiento de $ 10.00para un reembolso de la programa. Nombre del padre/guardián: Fecha Firma del padre/guardián:
9 SPRING BREAK FREE 3 DAYS BASKETBALL CLINIC 1-4 GRADES APRIL & 20TH PLAYER LAST NAME: PLAYER FIRST NAME: DOB: SCHOOL GRADE T-SHIRT HOME PHONE: CELL PHONE: STREET: TOWN NJ ZIP CODE: DAD S NAME MOM S NAME Acknowledgement of Risk & Waiver Release of All Claims I am, the parent and/or legal guardian of the minor, understanding both the minor and the inherent risks associated with participating in BASKETBALL, I believe the minor to be qualified to participate, in good health, and in proper physical condition to participate in such activity. I hereby release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless each of the release s from all liability claims, demands, losses, or damages on the minor s account caused or alleged to be caused in whole or in part by the negligence of the releases (employees, volunteers, board or otherwise), including negligent rescue operation and further agree that if, despite their release, I, the minor, or anyone on the minor s behalf make a claim against any of the releases from any litigation expenses, attorney fees, loss liability, damage, or cost may incure as the result of any such claim. I understand and acknowledge that there is a $10.00 processing fee for any program refund given. Printed Name of Guardian: Date Guardian s Signature:
10 VACACIONES DE PRIMAVERA- 3 DIAS DE ACADEMIA DE BASKETBALL 1-4 GRADO APELLIDO DEL JUGADOR NOMBRE T-SHIRT FECHA DE NACIMIENTO ESCUELA GRADO TELEFONO CELULAR DIRECCION CIUDAD NJ CODIGO POSTAL CORREO ELECTRONICO NOMBRE DEL PADRE NOMBRE DE LA MADRE Reconocimiento de Riesgos e indemnización de daños y perjuicios Yo soy, el padre y / o guardián legal del menor, y comprendo tanto al menor como los riesgos inherentes asociados con la participación en el BASKETBALL, afirmo que el menor esta calificado, tienen buena salud, y buena condición física para participar en dicha actividad. Por este medio libero, descargo y me comprometo a no demandar, y estoy de acuerdo en guardar y mantener exonerados (libre de culpa) a los miembros aquí mencionados de toda indemnización de daños, perjuicios, demandas o pérdidas causadas por el menor o supuestamente ser en parte o en su totalidad negligencia de los exonerados (estos pueden ser pero no se limita a empleados, voluntarios o miembros de la junta directiva), incluyendo cualquier negligencia de algún programa de rescate. Asimismo, acepto que si, a pesar de la falta de su permiso/renuncia, yo, el menor, o alguien en nombre del menor de edad presentar una reclamación contra cualquiera de los exonerados estos serán liberados de cualquier gastos de litigio, honorarios del abogado, responsabilidad de la pérdida, daño o cualquier costo que puede incurrir como resultado de dicha reclamación. Yo entiendo que hay un precio de procesamiento de $ 10.00para un reembolso de la programa. Nombre del padre/guardián: Fecha Firma del padre/guardián:
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