bright horizons loveland fall 18€¦ · director: jeremy bulen | 970-682-4898 |...

Mighty Kicks is a fun, exciting way to introduce

soccer to your child. Each innovative session is

designed to build your child’s motor skills, life skills,

self-confidence, and basic soccer skills.

Our proven, age-appropriate curriculum enhances

the soccer experience while leaving a lasting,

positive impression.

Complete this enrollment form and return it to Bright Horizons to register. All participants receive a Mighty Kicks t-shirt!

DIRECTOR: JEREMY BULEN | 970-682-4898 | NORTHERNCO@MIGHTYKICKS.NET

Enrollment Form

Child’s Name:

Date of Birth:

Class (if known):

Parent/Guardian’s Name: Phone: E-mail:

Medical Conditions (if any):

Release of Liability. Assumption of Risk and Indemnity. In Consideration of participating in the Mighty Kicks soccer program, I, the minor’s parent and/or legal guardian, understand the nature of this activity. My child is qualified, in good health, and in proper physical condition to participate in such activity. If I believe event conditions are unsafe, I will immediately discontinue participation. I fully accept and assume all risks and all responsibility for losses and damages that may incur as a result of my child’s participation. I hereby release, discharge, and covenant not to sue Mighty Kicks, its respective administrators, employees, other participants, and sponsors, and, if applicable, owners and leasers of premises on which the activity takes place, (each considered one of the “releasees” herein) from all liability, claims, demands, losses, or damages. I further agree that if, despite this release, I, or anyone on my behalf makes a claim against any of the releasees, I will indemnify, save, and hold harmless each of the releasees from any loss, liability, damage, or cost, which may incur as the result of such a claim. I have read the Release and have signed it freely and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law.

Media Release Mighty Kicks will occasionally take photographs and videos of classes to be used in marketing the program. If you DO NOT want a photo or video of your child ever used please check the box to the right.

I do not give my permission to use a photo or video of my child in any marketing products.

Signature of Parent or Legal Guardian Date

FallSeason-RegisterNow!

InSchoolSocceratBrightHorizons

Wednesdays@10:00

8weekseasonStartsWednesday9/12

Freedemoday9/5

Cost$953–5yearolds–noequipmentrequired