Volunteer Coach Membership Form - New Jersey Youth Soccer printable pdf download

Volunteer Coach Membership Form - New Jersey Youth Soccer

New Jersey Youth Soccer

Volunteer Coach Membership Form

(Type or Print Legibly)

First Name: _____________________ Last Name: ____________________________

Address: _______________________________________________________________

City: ______________________ State: ____ Zip: ______ Phone: ______________

Email Address: __________________________________________________________

League: __________________________________________League # ______________

Club: ____________________________________________Club # ________________

Coach License Level ____

IMPORTANT

I will abide by the rules and regulations of the US Soccer, US Youth Soccer, and New Jersey Youth

Soccer, its affiliated organizations and its sponsors. In consideration of the my participation in the soccer

programs intending to be legally bound, hereby release and indemnify the US Soccer, US Youth Soccer,

New Jersey Youth Soccer, the owners and operators of the facilities used for the Programs and their

respective directors, officers, employees, agents and representatives from and against all claims,

liabilities, damages or causes of action arising out of or in connection with the my participation in the

Programs including, without limitation, player’s transportation to/from any Program, which

transportation is hereby authorized. I further grant the US Soccer, US Youth Soccer, New Jersey Youth

Soccer and their sponsors the right to use my name, picture and/or likeness in printed, broadcast and

other material concerning the Programs provided such use is related to the player’s status as a participant

of in the Programs.

I hereby certify that I am not being compensated for my services and I am a volunteer.

Name: ____________________________ Date: ___________________________

Signature: ____________________________________________________

Volunteer Coach Membership Form - New Jersey Youth Soccer