Pleasure Island Soccer Association PO Box 1868, Carolina Beach, NC 28428
Rec Registration-Fall '19
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PISA Soccer Coaches Agreement
Indicates required field
Date of Birth
enter this format: MM/DD/YYYY. Must be at least Age 14.
Social Security #
Form will not be accepted without SS#
By clicking the Submit button below, you agree to have read the following Coach Agreement.
I do hereby declare my intent to participate as a coach in programs /activities associated with the Pleasure Island Soccer Association. I hereby release and hold harmless from any and all liability; Pleasure Island Soccer Association, coaches, sponsors, associated board members and personnel, and other officials, associated with this organization against any claim/ injury by or on behalf of my participation in this program. I understand that I am not an employee, nor under the direct supervision or direction of Pleasure Island Soccer Association, and not recognized under Federal or State law as such; therefore waive any access to and am not entitled to any benefits, including but not limited to; Workers Compensation, Employer’s Liability, Employment Practices, Equal Opportunity, Disability, Medical Coverage, Hospitalization, Accidental Death & Dismemberment.
I agree to abide by the rules & regulations of Pleasure Island Soccer. I will conduct myself in a professional manner at all times on and off the field. I will not confront any parent, coach, child, or other participant with regard to any grievances or complaints, but instead will refer to the PISA DOC & Director with all concerns. I will notify the PISA DOC & Director of any outburst, complaint, or unsportsmanlike conduct on the part of any parent, coach, player, or other persons. I understand that soliciting/charging additional fees for group/team training while during or while in perceived role as a coach for PISA is prohibited since outside the scope of the program. If there is any situation arises where there is questionable activity, I will notify DOC & Director to review my individual circumstances to determine if conflict of interest with PISA may be present.
Any failure to comply with the above or in a manner considered by Pleasure Island Soccer to be in the best interest of this organization may be free to discontinue at will, either on their own or by request of PISA.