Soccer for Success - Teacher Registration Form (Credit Card Purchase Only)

Please complete this form for access to the U.S. Soccer Foundation Learning Lab, powered by the U.S. Soccer Foundation and US Youth Soccer. The curriculum is designed for K-12 physical education teachers to use during the school day. The curriculum is aligned to national physical education standards and infuses communication and connection skills into every lesson. The curriculum provides educators with a turnkey resource to get kids active while improving their physical and health literacy.

If you are registering on behalf of a group of teachers, or registering on behalf of another teacher, please reach out to Lisa Perry at lperry@ussoccerfoundation.org, who can assist in setting up a group registration. The form below is only for you to gain access to the U.S. Soccer Foundation Learning Lab. If you cannot pay via credit card, you do not need to proceed with this form, and can reach out to Lisa Perry at lperry@ussoccerfoundation.org for support.

To learn more: https://ussoccerfoundation.org/schools

Questions? Email: LPerry@ussoccerfoundation.org

Please select your language.

Provide your personal details for registration.

First Name

Last Name

If you have previously registered for a U.S. Soccer Foundation training, please use the same email.

Date of Birth

Enter date using format: MM/DD/YYYY.

Gender

Ethnicity

Please enter information about your school district.

School District Name:

School District Street Address:

School District City:

School District State:

School District Zip Code:

Please enter information about the school where you will teach Soccer for Success.

School Name:

School Address:

School City:

School State:

School Zip Code:

Type of Play Spaces

IndoorsOutdoorsBoth

How many children will you serve at your school(s) through this Soccer for Success curriculum?

How many children are in your largest class?

How many soccer balls does your school currently have in inventory?

Payment Information

f you are registering on behalf of a group of teachers, or registering on behalf of another teacher, please reach out to Lisa Perry at lperry@ussoccerfoundation.org, who can assist in setting up a group registration. The form below is only for you to gain access to the U.S. Soccer Foundation Learning Lab. If you cannot pay via credit card, you do not need to proceed with this form, and can reach out to Lisa Perry at lperry@ussoccerfoundation.org for support.

To learn more: https://ussoccerfoundation.org/schools

Questions? Email: LPerry@ussoccerfoundation.org

Name on Card

Card Number

Code

Purchase Amount:

Email Opt In - By checking the box below, I agree to receive email communication from the U.S. Soccer Foundation inclusive of marketing, news, and other updates. I understand that submission of this registration will grant the U.S. Soccer Foundation permission to send communication directly related to my participation in the Soccer for Success School program, irrespective of my response.

I agree

Waiver - 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

Insurance - By checking the box below, I affirm that my school/school district carries appropriate insurance which protects its students on a primary basis from injuries including sexual abuse and molestation, personal injury, property damage and bodily injury liability. Additionally, my school/school district meets the statutory requirements for Workers Compensation liability insurance, covering all employees involved in this program. Self-insurance, as required by law, is an adequate replacement for the above-mentioned insurance coverages.

I agree

Employee/Volunteer Background Checks - By checking the box below, I affirm that my school/school district 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 school/district.

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