Coach-Mentor Training NCYS Resource Hub Registration

   

First Name

Last Name

Email

Date of Birth

Ethnicity

Please select... African-American and Black American-Indian/Native Alaskan Asian Caucasian Haitian Latino/Latina/Latinx and Hispanic Pacific Islander Other/Multi-Ethnic Prefer not to answer

Gender

Please select... Female Male Gender non-binary Prefer not to answer

By checking the box below I agree to U.S. Soccer Foundation's medical release/waiver/indemnity agreement and model release and authorization to video/photograph.

I agree

Employee/Volunteer Background Checks - By checking the box below, I affirm that my youth organization has a criminal history background check process in place for its employees, and that all employees or volunteers must be cleared through that process prior to beginning work for the organization.

I agree

Indemnification - By checking the box below, I agree to indemnify, defend and hold harmless the U.S. Soccer Foundation from and against any and all third party claims, demands, losses, damages, liabilities, costs and expenses (including reasonable legal/attorneys' fees and expenses arising out of or related to any legal proceeding and any legal appeal) ("Claim" or "Claims") related to the program and liabilities of any kind or nature whatsoever, whether in contract, tort, or otherwise, resulting from any claim (including, without limitation, personal injury, bodily injury, sickness or disease, death, or property damage) actually or allegedly arising out of or in connection with operation, location, or condition of the program, my failure to comply with any applicable state or local laws, or any person's participation in the program, whether authorized or unauthorized, proper or improper.

I agree