REGISTRATION FORM
AFTERSCHOOL SOCCER SKILLS @ NDA

 

ENROLLMENT AGREEMENT and WAIVER OF LIABILITY

I certify 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 location 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 the 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.

We reserve the right to cancel sessions due to low enrollment.

​I agree to supervise or designate an adult to supervise my child prior to and immediately after his/her BSM activities.

I agree that no medication will be administered to my child, except for EpiPen injection, for which I have to sign a separate consent form when submitting the EpiPen.

 

For promotional activities, BSM may utilize photographs and videos of participating children and their parents or caregivers while engaged in our activities. I consent to such use and waive all rights to compensation.

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.

COMMUNICABLE DISEASE RELEASE OF LIABILITY & ASSUMPTION OF RISK

In consideration of being allowed to participate in any way in the program, related events and activities, 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 disease, including but not limited to, Influenza, MRSA and 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, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS SJ Enrichment Inc. d/b/a 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 events or related activities (“RELEASEES”), from any and all claims, demands, losses, and liability arising out of or related 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 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.

I, the parent/guardian with legal responsibility for this participant, 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.

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PAYMENT, REFUND, CANCELLATION & GENERAL ENROLLMENT CONDITIONS

BSM guarantees a full prorated refund (minus a $30 administrative fee) for the season’s remaining sessions before the fourth session of any period. No refunds thereafter. No refunds for missed sessions.