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« 2007 Elections at November Board Meeting
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Old Temp

Coaches and or Board Member Form
  1. Bellingham Soccer Association Waiver
  2. I, the parent/legal guardian of the Registrant, a minor agree that I and the Registrant will abide by the rules of the USYSA (United States Youth Soccer Association), its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the USYSA accepting the Registrant for its soccer programs and activities (the "Programs").
  3. I hereby release, discharge, and/or otherwise indemnify the USYSA, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the Programs against any claim by or on the behalf of the Registrant as a result of the Registrant's participation in the Programs and/or being transported to or from same, which transportation I hereby authorize. I acknowledge that my child has been medically cleared to participate in this soccer program.
  4. Furthermore, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well-being of my dependent.
  5. In addition, I give my permission to the BSA to use pictures of my child on the BSA web site (no names attached to the photos) and in any type of publicity or fundraising campaigns for the Association.
  7. (required)
  8. (valid email required)
  9. (required)
  10. (required)
  13. Parent or Guardian check any if you are willing to volunteer?
  18. Parent 2 check any if you are willing to volunteer?
  20. (required)
  22. (required)
  23. (required)
  24. (required)
  26. Child 1 Gender
  29. Complete for any additional children
  32. Child 2 Gender
  34. Anti-spam protection stuff...
  36. Captcha
 

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This entry was posted on Friday, January 5th, 2007 at 3:25 pm and is filed under News. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

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