SJEB 21/22 Tryout Registration Form
Please fill out this form for our U8 - U19 Boys and Girls Teams - Current players do not fill out
Date of Birth
Parent Email 1
Parent Email 2
Parent Cell 1
Parent Cell 2
#2 - Right Back
#3 - Left Back
#4 - Right Center Back
#5 - Left Center Back
#6 - Center Mid
#7 - Right Mid/Wing
#8 - Box to Box Center Mid
#9 - Center Forward
#10 - Attacking Center Mid
#11 - Left Mid/Wing
Check Box if interested in Girls Academy League
Link to Highlights (youtube, hudl, etc)
COMMUNICABLE DISEASE RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT
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, 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 and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY
RELEASE, INDEMNIFY, AND HOLD HARMLESS NJ YOUTH SOCCER AND THE (NAME OF
ORGANIZATION), its officers, officials, agents and/or employees, other participants, sponsors,
advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES),
from any and all claims, demands, losses, and liability arising out of or related to any ILLNESS, INJURY,
DISABILITY OR DEATH I may suffer, WHETHER ARISING FROM THE NEGLIGENCE OF THE
RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and
agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and
next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability
incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF
ARISING FROM THE NEGLIGENCE OF THE RELEASEES, 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 ELECTRONICALLY BY CHECKING THE BOX BELOW AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Check box to agree to the COVID 19 Waiver
I agree to the terms of the waiver
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