2024 Waiver

Player's Name *

First

Last

Class/League Enrollment

Thursday League

League Team Name (Mandatory) *

Mailing Address *

City *

State *

Zip Code *

Email *

Alternate Email

Mobile Phone *

Work Phone

Home Phone

Emergency Contact Name *

Emergency Contact Phone *

Do you have ANY medical condition or allergy that we need to know about, particularly any condition that may impede breathing (like asthma, food allergies, reactions to bug bites, etc)? *

Describe Condition Here (All information is kept confidential) *

Are you required to take ANY type of over-the-counter or prescription medication, including but not limited to inhalers, breathing treatments, or rescue-aids like an epi pen? *

Describe Medication Here (All information is kept confidential) *

I understand that I will be responsible for following all mandated Covid-related safety procedures while participating in TSLC activities. Non-compliance in any way will result in immediate expulsion and forfeiture of all fees paid. There are no exceptions to this guideline. *

I agree. Continue on to sign waiver.
I don't agree. Please cancel my registration.

READ THIS WAIVER CAREFULLY. TO CONFIRM, CLICK AGREE, SIGN & DATE BELOW: By clicking on "I agree" and signing my name below, I certify I am the above registered player who wishes to participate in soccer related activities at The Soccer Learning Center (referred to as Activity). I have disclosed any pertinent medical information in this document and certify that I have been cleared by my healthcare provider to participate in The Soccer Learning Center Activity. I certify that I will follow all staff directions related to all safety procedures in place at the time of my Activity including COVID-19 policies that cover proper mask wearing, hand sanitization, social distancing, temperature checks and any other procedure or practice necessary as recommended by the CDC and health department guidelines. I understand that if I am unwell I should not attend any TSLC Activity. I understand that personal information may be required to be distributed to contact tracers or the local health department per their directives. I also certify that I am of the required class age and understand that if I do not produce documents verifying my age, I will be removed from class and I will forfeit 100% of my tuition. I acknowledge that the nature of the classes at The Soccer Learning Center may expose me to hazards or risks that may result in illness, personal injury or death. I understand and appreciate the nature of such hazards and risks. In consideration of my participation in the Activity, I hereby accept all risk to my health and of my injury that may result in such participation and I hereby release Team Raja, LLC DBA The Soccer Learning Center, it officers, employees, and representatives from any liability to me, our personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to our property and for any and all illness or injury to me that may result from or occur during my participation in the Activity, whether caused by negligence of Team Raja, LLC, its officers, employees or representatives or otherwise. I further agree to indemnify and hold harmless Team Raja, LLC, its officers, employees, and representatives from liability for the injury of any person(s) and damage to property that may result from my negligent or intentional act or omission while I participate in the described Activity. I understand that NO ALCOHOL, ILLICIT DRUGS OR CONTROLLED SUBSTANCES OF ANY KIND (OTHER THAN THOSE THAT ARE LEGALLY PRESCRIBED BY A PHYSICIAN) CAN BE CONSUMED ON THE PREMISES, INCLUDING IN THE COMMON AREAS OF THE LOCATION WHICH INCLUDE THE LOBBY, RESTROOMS AND PARKING LOT AREAS. IF ANY PLAYER IS SUSPECTED OF BEING UNDER THE INFLUENCE OF ALCOHOL OR ILLICIT DRUGS OR IS SEEN CONSUMING ALCOHOL OR ILLICIT DRUGS, THEY WILL BE REMOVED FROM THE PREMISES AND RISK EXPULSION/TEAM ELIMINATION FROM THE SOCCER LEARNING CENTER WITHOUT A FEE OR TUITION REFUND. I understand that children of any age are not permitted to accompany me to any TSLC Activity and that bringing a child to my Activity will expose them to danger or injury. I hereby release Team Raja, LLC DBA The Soccer Learning Center, it officers, employees, and representatives from any liability to me or any child or guest, our personal representatives, estate, heirs, next of kin, and assigns for any and all claims and causes of action for loss of or damage to our property and for any and all illness or injury to me, any child or guest that may result from or occur during my participation in the Activity, whether caused by negligence of Team Raja, LLC, its officers, employees or representatives or otherwise. I further agree to indemnify and hold harmless Team Raja, LLC, its officers, employees, and representatives from liability for the injury of any person(s) and damage to property that may result from my negligent or intentional act or omission while I participate in the described Activity. I understand that once I register for this Activity, I have reserved a space that is non-refundable for any reason. I understand that if I dispute this policy and try to reverse a valid merchant charge or check with my banking institution, The Soccer Learning Center reserves the right to file collection and/or legal actions to ensure the recovery of the disputed tuition amounts plus all applicable fees and damages including charges for the time required to dispute and adjudicate such claims. Note: When you click the AGREE button on the Registration and/or Waiver page, you certify that you have read, understand and agree to abide by ALL of THE SOCCER LEARNING CENTER policies noted on this page, our Rules page, our Waivers page and the Registration page. If you have any questions, we encourage you to call The Soccer Learning Center at 201-656-1156 or email us at CoachAlex@SoccerLearningCenter.com. *

I agree to all waiver terms.
I do not agree, please cancel my registration.

Player's Electronic Signature *

Player's Date of Birth (must be age 21 or older) *

Today's Date (mm/dd/yyyy) *

Name

The Area's Best Indoor Co-Ed Soccer Program for Adults

Mailing Address

The Soccer Learning Center
P.O. Box 1152 Secaucus, New Jersey 07096-1152

Office: (201) 656 - 1156
Coach Alex Lalaoui: (201) 920-8523
Fax: (201) 839-9886
CoachAlex@SoccerLearningCenter.com

Adult Program Registration

Children's Program Registration

Locations

Outdoor @ Shetik Field
225 County Avenue
Secaucus, NJ 07094

Free parking on site

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Indoor @ Humboldt Gym
123 Centre Ave
Secaucus, NJ 07094 (Side Door Entrance)

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