Clipboard with pencil checking boxes.
WAIVER OF LIABILITY AND RELEASE FORM

I authorize that an unaltered copy of this form may be generated and given to the officers or directors of other leagues or tournaments in order to allow my participation in their soccer programs, if the form is required and I have requested to participate. I hereby release, waive liability, discharge, hold harmless, indemnify, and covenant not to sue, North Bay Village, the league and tournament, their associated directors, administrators, officers, managers, employees, coaches, referees, trainers, volunteers, sponsors and advertisers, and other agents, estates or executors, from any and all liability incurred in the conduct of, and my participation in, their soccer programs. This includes owners, lessors, and lessees of premises, municipalities, government agencies, successors, heirs, and assigns. I have completely read this document and fully understand its contents. I acknowledge that I have given up substantial rights by accepting this document and that I do so voluntarily. My signature attests to this on behalf of myself and my executors, personal representatives, administrators, heirs, next-of-kin, successors, and assigns.

NBV Competitive Soccer League Fall Registration
Used to contact you in case of problem with payment
Yes No
For emergency contact use
1 NBV Resident - $275.00 2 NBV Resident - $500.00 3 NBV Resident - $725.00 1 Non-NBV Resident - $325.00 2 Non-NBV Resident - $600.00 3 Non-NBV Resident - $875.00
Payment method
Payment Details
Payment amount
Municipal Online Payments Fee (Credit Card) $1.25
Total
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