<p> Fourth Annual Francis Brian Steets Soccer Shoot ROSELAND RECREATION AND THE LIVINGSTON ELKS ARE CO-SPONSORING THE TWELFTH ANNUAL OVERALL SOCCER SHOOT COMPETITION ’14 For All Area Resident and Non-Resident Boys & Girls - Ages U8 to 13 FRIDAY, OCTOBER 10th Noecker School New Gym 100 Passaic Avenue, Roseland, NJ 07068 Age Group: (AGE AS OF 8/1/14) U8 (6:00 p.m.), 8-9 (6:45 p.m.), 10-11 (6:00 p.m.), 12-13 (6:45 p.m.) Check in and/or Post (Same Day) Registration – Friday, October 10th (Noecker Gym) – 15 minutes before each scheduled start time. </p><p>Trophies are awarded to First, Second, and Third Place finishers in each category and presented at the Annual Awards Party in January 2015. In addition, First Place finishers will have an opportunity to advance to District, State, and Regional Competition. Come out and test your skills!</p><p>Competition participants will receive 3 warm-up kicks, and 15 contest kicks. Scores are determined on accuracy. The highest point total determines the winners.</p><p>Mail or walk in the completed Registration form to 140 Eagle Rock Avenue, Roseland, NJ 07068 with a copy of participant’s Birth Certificate on Monday – Friday from 8:30 a.m. - 4:30 p.m. </p><p>A copy of participant’s birth certificate must accompany the form (Document is used for age verification) Pre-registration deadline is Wednesday, October 8 th . For more information please call Rich Vreeland at 973/228-2288 or Roseland Recreation at 973/403-6850 - COMPETITION IS FREE ------Please Note: One Form Per Participant Detach Here BC____ FRANCIS BRIAN STEETS SOCCER SHOOT COMPETITION CHILD’S NAME ______PHONE NUMBER______ADDRESS______CITY______STATE____ ZIP______BIRTH DATE ______SEX ______AGE AS OF AUG. 1, 2014 ______E-MAIL______In return for being allowed to participate in the Roseland Recreation Department (hereinafter referred to as “RRD”)/ Benevolent and Protective Order of Elks of the United States of America’s Soccer Shoot, the undersigned parent represents the information set forth in the Application is correct. In consideration of such registration and the right of applicant to participate in the competition, the undersigned does hereby acknowledge and agree that such participation will be solely at the risk of applicant, the undersigned, and without liability to the RRD/Benevolent and Protective Order of Elks of the United States of America, its State Associations, its subordinate Lodges, and the officers and member of them (hereinafter collectively referred to as “BPOE”) and any other Sponsors. The undersigned, for himself, his personal representatives and successors, does hereby release and forever discharge RRD/BPOE and any other Sponsors from any and all claims, demands, liabilities, obligations, damages, costs, expenses, loss of service, actions and causes of action including each and every right of payment for damages said undersigned may now or hereafter have against RRD/BPOE and any other Sponsors arising out of any act or occurrence incident to the applicant’s said participation and/or the engagement of the undersigned in connection therewith. The undersigned hereby gives consent and authorizes RRD/BPOE to use and reproduce, without compensation, applicant’s name and/or likeness and to circulate the same for any and all purposes reasonably related to the conduct and promotion of the said competition, and the undersigned does hereby agree to indemnify and hold RRD/BPOE and any other Sponsors harmless from any and all claims, loss or damage to the RRD/BPOE resulting from or related to applicant’s said participation. ______(Signature of Contestant) (Signature of Parent of Guardian)</p><p>NOTE: All entrants are requested to contact their school principal or coach to determine if any restriction or eligibility requirements exist in their state.</p>