KSA registration form
Kids Soccer Academy (KSA HOUSTON)
9585 CLAY RD #11- HOUSTON, TX 77080
281.846.4703 (text) ksaHouston1@gmail.com
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Email *
Mobile Number *
First Name, Last Name (Parent) *
Name (Child) *
Date of Birth (child) *
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Release & Liability Waiver *
RELEASE AND WAIVER OF LIABILITY AGREEMENT By Agreeing to this release and waiver of liability, the participant agrees that KSA is not responsible for injuries or harm to any of the participants.  KSA is conducting a soccer class and training program that may involve some physical contact.  Such contacts may result in bodily injury and/or harm beyond the control of the facility and or its staff members.  YOU ARE AWARE THAT THESE ACTIVITIES ARE PHYSICAL ACTIVITIES AND THAT I COULD BE SERIOUSLY INJURED OR EVEN KILLED. YOU ARE VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN.BY agreeing to this WAIVER you verify this statement as the Parent or Guardian’s (if under participating party is under 18)To participate in these activities and use the KSA premises and facilities, I forever release KSA, the State of Texas, the County, the Lessor, any KSA affiliated organization, and their respective directors, officers, employees, volunteers, agents, contractors, and representatives (collectively “Releases”) from any and all actions, claims, or demands that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives now have, or may have in the future, for injury, death, or property damage, related to (i) my participation in these activities, (ii) the negligence or other acts, whether directly connected to these activities or not, and however caused, by any Release, or (iii) the condition of the premises where these activities occur, whether or not I am then participating in the activities.  I also agree that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives will not make a claim against, sue, or attach the property of any Release in connection with any of the matters covered by the foregoing release. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS.  I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND KSA, THE STATE, THE COUNTY, AND THE LESSOR,  AND SIGN IT OF MY OWN FREE WILL.  If Signed by Parent or Guardian:  I verify that the dangers of the activities and the significance of this Release and Waiver were explained to the Participant and that the Participant understood them.
Class Day & times (select one)
Payment Options... Program is available year round *
45 minutes class developing and challenging more advanced skills.  Focused foot-work and coordination to maintain ball control, dribbling, passing and kicking skills.  Social development, through listening and following directions of various games and activities.  Encouraged team work. Goals to accelerate better concepts of soccer, prep for league play.  6 consecutive classes If class is missed, may roll over one (1) class as a make-up.
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