ADULT TEAM SOCCER LEAGUE FORM

August 2024 League Registration Form

Team Information

Team Name ( Type in House Team if signing up as free agent )

Coach / Player or guardian *

First NameLast Name

Player name if different from above

First NameLast Name

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

E-mail*

Skill Level

GoodAverageBelow Average

Team Roster

Payment information *

Team League Deposit $100.00

Free Agent $70.00

Signing up as Free agent in the house team

Quantity

Total $0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Informed Consent and Acknowledgement

I hereby give my approval for participation in any and all activities prepared by Q&B SPORTS LLC during the league. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Q&B SPORTS LLC . and all its respective officers, agents, and representatives from any and all liability for injuries to said player arising out of traveling to, participating in, or returning from selected sessions.

In case of injury to said player, I hereby waive all claims against Q&B SPORTS LLC . including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including soccer. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.