CALAVERAS INDOOR SOCCER LEAGUE PLAYER FIRST __________________ LAST ____________________ MAIL ADDRESS _____________________________________ CITY_____________________ ST _______ ZIP_____________ DOB __________________. MALE. Or. FEMALE CELL # _______________ HOME # ______________________ EMAIL _____________________________________________ IF player is Under 18 years of age PARENT / GUARDIAN ____________________________________________________ CELL # ______________________ HOME __________________ GRADE ___________ SCHOOL _________________________ CONSENT : I - PLAYER / PARENT or GUARDIAN __________________________________________(print name) Understand the above listed player/ self, do agree and give my Permission for participation in a CALAVERAS INDOOR SOCCER LEAGUE / KELLY SOCCER ACADEMY. I hereby give consent for Emergency medical care prescribed by a duly licensed doctor of medicine or doctor of dentistry, if I am unable to consent in person, Or by phone. I /we agree that every effort will be taken to insure the Safety of every participant with the condition C.I.S.L. Kelly soccer academy, requires SHINGUARDS to be worn in order to play. NO GUARDS = NO PLAY. I /we also agree to abide to the CODE OF CONDUCT, for coaches, players referees and spectators. Which is Is SPORTSMANSHIP is a must and NO FOUL LANGUAGE. I And WE agree that the employees, officers, directors, and coaches Of C.I.S.L. / KELLY ACADEMY and Calaveras Unified School District, Colleen Kelly, will not be liable or responsible for accidents or Injuries occurring during or at activities, warm-ups, or games. I /we Understand that participation constitutes my/our approval for the use Of photographs for publicity and promotion at colleen kellys discretion SIGNATURE_____________________________DATE____________ Absolutely no refunds. TSHIRT SIZE __________________
Posted on: Sun, 12 Oct 2014 05:04:57 +0000
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