Pacific Coast Academy

Parent *

First Name / Last Name

Soccer Player *

First

Last

First Name / Last Name

Age / Date of Birth *

First

Last

What do we need to work on? *

Intoduction/Evaluation/Calibrate/Control

Pacific Coast Academy *

8 Lessons $480

TLU Player T-shirt

Training

(Adult Size) or (Youth Size) $27 *

X-small
Small
Medium
Large
X-large

Checkbox Items *

1 TLU Training Shirt $27.00
3 TLU Training Shirt $75.00

Phone Number *

Email *

What level do we Love Soccer

Selected Value: 10

Signature *

Clear Signature

NOTE: The last day Pacific Coast allows us to host lessons is on May 31st. LESSONS DO NOT ROLL OVER.

Terms of Service I understand and agree to the terms. *

I accept the terms of service: I, the undersigned, in consideration for my voluntary participation in organized soccer, do hereby willfully acknowledge that my signature below attests to my understanding and agreement that: Soccer is a physical, contact, sport that involves the risk of injury. I assume all risks and hazards associated with my participation in the sport. I am in proper physical condition to participate in soccer lessons, practices and games and have no illness, disease or existing injury or physical defect that would be aggravated by my participation. I will inform my coach if this status changes. I further acknowledge that this risk may involve loss or damage to me or my property, including the risk of death, or other unforeseen consequences, including those which may be due to the unavailability of immediate emergency medical care. I have a current medical consent form in force. I will wear shin guards, properly fitted and appropriate shoes, and other protective equipment (e.g., mouth pieces), as provided by soccer rules, to all events. Team lion United does not have personal injury insurance that covers my participation. Therefore, I should have a current, active, personal injury insurance policy in force, which covers my participation. Under any condition, I am responsible for any and all medical expenses arising from my participation, both in practices and games and while travelling to and from these events. I have the right and responsibility to inspect the equipment and facilities prior to events and, if I believe that anything may be unsafe, I will advise the coach or supervisor of the condition and may refuse to participate. Participation assumes consent. I authorize my photograph, picture or likeness, and voice to appear in any documentary, promotion (including advertising), television, social media you tube, instagram, facebook video, or radio coverage of the league or tournament, without compensation. 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, Team Lion United, Alonso Saavedra (Coach Alonso) the Club, the league and or tournament, their associated directors, administrators, officers, managers, employees, coaches, 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. All sessions must be completed with 6 months of the 1st session unless any sessions are canceled due to heavy heat or rain-outs. No refunds or returns. 24 hours is required for any cancellations other than weather issues.

Total

$0.00

Square *

Card

Name on Card

Team Lion United Office Hours