2016-17 Current Season Travel Team Payments

* Player First Name:
* Player Last Name:
* Street:
Apt. #:
* City:
* State:
* Zip Code:
* Home Phone:
* Parent / Guardian Name:
* Parent / Guardian Cell Phone:
* Primary Email:
* Secondary Email:
* Players Birthdate:
* Gender:
* Team / Birth Year:

Parental Waiver and Consent

As the parent or legal guardian of the child named above (the “registrant” or “my child”), I hereby give my full consent and approval for my child to participate as a
team member in the Fort Lee Soccer League. Both the registrant and I agree to abide by the rules of the Fort Lee Soccer League (which rules are subject to change
from time to time in the sole discretion of Fort Lee Soccer League and which may be viewed at www.fortleesoccer.com. I hereby represent that my child has been examined by a duly licensed medical doctor and that he/she is physically and mentally fit to participate in the Fort Lee Soccer League. I understand that there are certain risks of injury (some serious) inherent in the practice and play of soccer, as well as in traveling and other related activities incidental to my child’s participation in Fort Lee Soccer League, and I am willing to assume these risks on behalf of my child. I hereby give my consent and permission to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide my child with
medical assistance and/or treatment deemed, in the sole judgment of Fort Lee Soccer League and/or such medical provider, to be necessary to preserve life, limb,and/or the well being of my child and I agree to be financially responsible for the cost of such assistance and/or treatment. In the case of an emergency, I hereby authorize treatment and care of my child by any hospital, doctor, or emergency or ambulance association or service.

In addition to giving my full consent and approval for my child’s participation in Fort Lee Soccer League, and in consideration for Fort Lee Soccer League accepting my child for such participation, I do hereby release, discharge, indemnify, and/or otherwise hold harmless, Fort Lee Soccer League and any person or entity related in
any way to Fort Lee Soccer League, including, without limitation, its trustees/directors, officers, employees, coaches, assistants, volunteers, supervisors, representatives and sponsors (including, without limitation, the Borough of Fort Lee Board of Education and its members, associated personnel, sponsors and employees; the Borough of Fort Lee and its officials, associated personnel, sponsors and employees; and NJYSAand US Club Soccer and its members, officers, associated personnel,
sponsors and employees) and any and all owners of fields and facilities utilized for the Fort Lee Soccer League program for any injury that may be suffered by my
child associated with his/her participation in Fort Lee Soccer League and the activities incidental thereto and/or being transported to or from Fort Lee Soccer League programs, which transportation I hereby expressly authorize, whether the result of negligence or any other cause. In the event that I become involved in a legal proceeding with Fort Lee Soccer League and Fort Lee Soccer League prevails in such legal proceeding, I hereby agree to reimbursement Fort Lee Soccer League for its reasonable attorneys’ fees and costs in such legal proceeding.

I further grant Fort Lee Soccer League and its sponsors the right to use photographs of my child and/or his/her likeness in printed, broadcast and other material concerning Fort Lee Soccer League, including, without limitation, on its printed materials or on its website(s), without payment of any consideration.

Parent’s Code of Conduct

With my acceptance, I hereby signify that

1. I promise to treat all players (including the opposing players) as well as the opposing coaches, all fellow spectators, the referees and League coordinators with
respect as I would want my own children, family and friends treated.

2. I will respect the officials and their authority during games and will never question, discuss, or confront coaches at the game field, and will take time to speak with coaches at an agreed upon time and place.

3. No food or no smoking within the field facilities is permitted.

4. As an adult, I will and must set a good example for the youngsters who will follow our conduct. I will teach my child to play by the rules and to resolve conflicts without resorting to hostility or violence. I (and my guests) will not engage in any kind of unsportsmanlike conduct with any official, coach, player, or parent such as booing or taunting; refusing to shake hands; or using profane languages or gestures.

5. I will not enter the playing surface during the game for any reason unless invited by the referee or a League Board member.

6. Promptness and attendance to all games and practices is required. Coaches, upon approval from the Board of Directors, may suspend or limit the participation of a player for missing a practice or game. Parents must immediately notify their child’s coach if they will be missing a practice or game for a legitimate reason.

7. I understand that only certified coaches may coach or provide direction to the players. I will refrain from interfering by shouting directions at the team during play. I will remember that the program is for the benefit of the children and not to satisfy my own ambitions or desires.

8. Persons violating this code of conduct will be required to leave the facility immediately AND subject to additional punitive measures by the league. This violation will include either a written warning from the league, parental game(s) or season suspension, which would prevent the parent from entering any facility during which any soccer practice or game is being conducted.

9. I understand that it is my responsibility to know the rules of the Fort Lee Soccer League (which are posted on www.fortleesoccer.com). By registering and signing my name to this form, I agree to abide to the League Rules and to the Code of Conduct in it’s entirety.
Any parent knowingly providing false information, as a signature that is not the parent’s on the Code of Conduct will have their registration fee forfeited and their child will be automatically terminated from the League. Any parent violating any portion of the Code of Conduct will be required to leave the playing field.



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