Please register for this event using the form below: There is no refunds on this camp.
First Name
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Last Name
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Date of Birth
*
Email
*
Address
*
City
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State
*
- - Choose One - -
Alabama
Alaska
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Zip
*
T-shirt Size
YM
YL
Adult XS
Adult M
Adult L
Adult XL
# of Team Players Attending
Team Name (optional)
Age Group Fall of 2008
*
u9u10 girls: 8am-10am
u11 girls: 10:30-am 12:30pm
u12 girls: 1:30pm-3:30pm
u13u14 girls: 4pm-6pm
u15-u17 girls: TBD
Evening Scrimmages
Liability Waiver/ Medical Information-I, hereby release Elite Coaching, LLC, Chastain Soccer Academy, LS R7 School District, and all associates, employees, volunteers, officials and agents associated with this program and facilities from any claims, liabilities, loss of services, and causes of action of any kind of personal injury including death and property damage arising in any way out of participation. I hereby authorize the supervisors of Elite Coaching, LLC, Chastain Soccer Academy to act for me according to their best judgment in an emergency requiring medical attention. My son/daughter is fully covered by our personal family health plan in the event of sickness or injury. Parents and guardians must inform Elite Coaching, LLC and Chastain Soccer Academy of any and all special health needs. Elite Coaching, LLC reserves the right to utilize images and/or pictures of all program participants for Elite Coaching, LLC and MVP Sports KC, LLC publications and promotions.
Date
Parent or Legal Guardian Digital Signature -Please Type Name Agreeing with the Liabilty Waiver
*
Insurance Company
*
Primary Insured
Policy Number
Relation