Spring 2008 Individual Online Registration Form (17 & Under)

Online Registration (Individuals 17 & Under)
Competitive Indoor Soccer Spring 2008

These games will be sanctioned under the rules of the United States Indoor Soccer Association.
All games are played full-field (200' x 80').

Now More Convenient Than Ever Before!

Our customers have asked for an all-in-one online registration form and Waiver of Claim for quite some time. Well... it's finally here!

Our insurance carrier has authorized use of the following all-inclusive registration form and waiver acceptance process. It's quick, easy, and just as valid as the handwritten forms.

Just complete the registration form below in its entirety. Make sure to review the Kids, Incorporated Waiver Of Claim (outlined below) to determine whether you prefer to complete this form online, or if you would rather submit a hard copy to our office. Once you hit the SUBMIT button below, a copy of the information you have submitted will appear. You may print a copy for your records if you like.
We thank you for your participation in our program. Have a great day!

Referee and Player Fees

All players must pay a $10 I.D. Card fee (valid Nov. 1, 2007 - Oct. 31, 2008) and a $50 player fee before their first game. A $10 discount will be extended on additional fees for players playing on multiple teams.

Participant Information

I am already on a team. Team Name: Coach:
I am not a member of a current team. Please Note: Teams participating in our competitive indoor soccer program will be formed by coaches and/or parents seeking an advanced level of play for their child. Kids, Incorporated is not involved in the actual team formation process.

Level of Play

A participant must be 17 years of age with parents consent to play in the adult leagues.

Select One: Select One:

Age as of July 31, 2007: Birthdate:

Player Information

Last Name:         First Name:         Gender:
Address:   City: State: Zip:
Home Phone:  Work Phone: Mobile Phone:
Email Address:
Emergency Contact:   Emergency Telephone:

Parent/Guardian Information (Required for participants under 18 years of age)

Last Name: First Name: Relationship:
Address: City: State:                  Zip:
Home Phone:    Work Phone:    Mobile Phone:

Existing Medical Conditions

Does this child have any disabilities, handicaps, present injuries or limitations, allergies, hemophilia, heart condition, history of respiratory illness or any other significant medical condition?)

      If yes, please state conditions:

Refund Policy

100% of the fee may be refunded if a player decides to terminate participation prior to the first game of the season. There will be no refunds after your team's first game has been played. Referee fees are nonrefundable after schedules are released.

Kids, Incorporated Waiver Of Claim

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL CONSENT AGREEMENT
("AGREEMENT")

IN CONSIDERATION of being permitted to participate in any way in a KIDS, INCORPORATED activity ("Activity") I, for myself for personal representatives, assigns, heirs, and next of kin:

ACKNOWLEDGE, agree, and represent that I understand the nature of KIDS, INCORPORATED Activities and that I am qualified , in good health, and in proper physical condition to participate in such Activity. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the Activity.

FULLY UNDERSTAND THAT: (a) KIDS, INCORPORATED ACTIVITIES INVOLVE RISKS AND DANGERS OF SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH ("RISKS"); (b) these Risks and dangers may be caused by my own actions or inaction’s, the actions or inaction’s of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE "RELEASEES" NAMED BELOW; (c) there may be OTHER RISK AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation or that of the minor in the Activity.

HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE KIDS, INCORPORATED, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owner and lessors of premises on which the Activity takes place, (each considered one of the "RELEASES" herein) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT I, or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

MINOR RELEASE

AND I, THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF KIDS, INCORPORATED ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, 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 RELEASEE’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 "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATION AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNITY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

NOTE: No child will be allowed to participate in any Kids, Incorporated activity until this form is on file in the Kids, Incorporated office. Forms received online without the agreement box checked below are considered null and void until a valid and signed waiver is in place. Parents/legal guardians may prefer to come to the Kids, Incorporated office to complete a hard copy of this form.

Please check ONLY one of the following:

YES, I acknowledge that I have read, understand, and agree to the terms and conditions of the Kids, Incorporated Waiver of Claim as outlined above. The original copy of this online registration form will become part of the official team roster and will be retained by Kids, Incorporated. A photocopy of this form may be presented to my child's coach.

OR

NO, I prefer to submit a hard copy of the Kids, Incorporated Waiver of Claim. I will submit a handwritten form to the Kids, Incorporated office and understand that my child may not participate until this form has been received and recorded on the official team roster in the Kids, Incorporated office.

Name of Parent or Legal Guardian (If participant is under the age of 18)
Name of Participant:
Today's Date: