ACADEMY TEAM REGISTRATION FORM
YOU MUST COMPLETE STEPS 1 AND 2 AS OUTLINED BELOW TO SECURE YOUR ROSTER SPOT.
STEP 1: Registration with BSM. Please complete this form. Payment must be made via debit or credit card in the next page. Without payment, the registration is incomplete. Your roster spot is secured only if you submit the payment along with this form.
STEP 2: Proof of Birth and Picture. Please upload a digital picture (head shot) AND birth certificate (or passport) in image format (JPG, JPEG, PNG, TIFF). Document files (PDF, DOC) are NOT accepted.
* ALL INFORMATION MUST BE SUBMITTED WITHIN 72 HOURS AFTER RECEIVING THE INVITATION LETTER.
* WITHOUT THIS FORM, NO PLAYER WILL BE PERMITTED TO PARTICIPATE IN ANY TRAINING SESSIONS OR GAMES BEYOND AUGUST 1, 20__22__. ALL EXISTING PLAYER PASSES EXPIRE ON JULY 31, 20__22__.
*PLEASE, READ, SIGN AND DATE THIS FORM. UNSIGNED FORMS WILL NOT BE PROCESSED
ALL PAYMENTS ARE NON-REFUNDABLE. NO EXCEPTIONS.
DUAL CARDING IS ALLOWED. Players do not have to leave their local town team –they can combine both teams. HOWEVER, PLAYERS MUST MAKE THEIR COMMITMENT TO BSM AS THEIR ATHLETIC PRIORITY FROM SEPTEMBER THROUGH JUNE. Plus, the town team should NOT be participating in EDP or NPL events, and players must submit their town team’s practice and game schedule to their BSM head coach.
ENROLLMENT AGREEMENT and WAIVER OF LIABILITY
, am the parent or guardian of
that my child has no known medical or other conditions that could interfere with his/her participation in BSM activities.
I also accept that the practice of soccer, both indoor and outdoor, involves certain risks of physical injury. Therefore, I hereby release, discharge, and hold harmless BSM, any of its directors, members, agents, employees or volunteers, and the owners, lessors of premises used and any of its staff, from any and all claims whatsoever, including but not limited to any claim of negligence or gross negligence that could otherwise be asserted arising out of or relating to any injuries that may result to any child while participating in any BSM activity, or as a result of such activities.
I understand and agree that BSM Directors have the right to terminate the enrollment of any child from BSM if the Directors, at their sole discretion, determine that the continued attendance of the child in the program is not in the best interest of the child nor the program.
I agree to supervise or designate an adult to supervise my child prior to and immediately after his/her BSM activities.
For promotional activities, BSM may utilize photographs and videos of participating children and their parents or caregivers while engaged in our activities. By signing below, you consent to such use and waive all rights to compensation.
I grant permission to BSM to transport my child(ren) to or from places where BSM holds its activities, and agree to hold harmless BSM and to assume all risk of damage or injury, including death, however caused, whether by negligence of the driver(s), owner(s) or otherwise, by acts of other children or by other third parties, while in or about the vehicle. I agree that neither they nor their heir will make any claim against or sue BSM driver(s) or vehicle owner(s), and waive all rights, claims and causes of action against BSM driver(s) or owner(s) or otherwise.
DISEASE WAIVER OF LIABILITY
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. It is believed that an individual can be in infected with COVID-19 without their knowledge and be asymptomatic. BSM has put in place preventative measures to reduce the spread of COVID-19. However, BSM cannot guarantee that I or anyone else will not become infected with COVID-19, including my spouse, guests, unborn child, or relatives. Participation in a BSM program(s), related event, or activity, could increase the risk of contracting COVID-19. The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) to my child from the activities involved in these programs are significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist.
FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child’s participation.
I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately.
I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS BSM; its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property incident to my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
I, the parent/guardian, assert that I have explained to my child/ward: the risks of the activity, his/her responsibilities for adhering to the rules and regulations, and that my child/ward understands this agreement.
PAYMENT, REFUND, MAKE-UP and GENERAL ENROLLMENT CONDITIONS
Payments are non-refundable. No refunds will be given. No exceptions. No credits or refunds will be issued for missed practices or games.
In order for the registration to be processed, you must first make a deposit in the amount of your child’s designated age group. We will not process registrations without corresponding payment.
BSM Elite Academy Team program is a 9-month commitment from September to June. Players will not be released until this 9-month commitment is over. The total cost of the program is explained in the email containing the invitation letter. Once you agree to join the program, you have the obligation to pay the total cost of the program. In the event that your account becomes past due and is referred by BSM to an outside collection agency or attorney, you will be responsible for the cost of collection services at the rate of 35% of the balance due, along with reasonable attorney fees and court costs incurred by BSM.
Your questions or comments are always welcome. Feel free to contact us via telephone or e-mail at any time.
By signing and dating below, I, for myself, my spouse, and child/ward, have read all enrollment conditions, release of liability and assumption of risk agreement, fully understand its terms, understand that we have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.
Please indicate how you heard about us by circling one of the following options: *
YOU MUST COMPLETE THE PAYMENTS IN THE NEXT STEP IN ORDER TO COMPLETE YOUR REGISTRATION.