2019 St Patrick Youth Soccer Clinic Registration

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Birthday *
MM
/
DD
/
YYYY
Which date(s) will you attend? *
Required
Guardian who will be the primary contact person *
Your answer
Primary Guardian's Email *
Your answer
Primary Guardian's Phone *
Your answer
Second Guardian's Name
Your answer
Second Guardian's Email
Your answer
Second Guardian's Phone
Your answer
Photo Release *
Chose one option
Required
Code of Conduct *
The mission of SPAA is to build community, character and virtue through youth and adult sports in a fun and faith filled environment. By participating in SPAA events participants agree to uphold this mission and the values of our Christian faith in both actions and words. Every person is a special creation of our Lord and as such deserves to be treated with dignity and respect. By signing this document I agree: 1) To treat everyone I encounter at an SPAA event with love and respect. 2) Not to use foul language, racial or ethnic slurs or the Lords name in vain. 3) Not to engage in any behavior that will endanger the health, safety or well-being of any other participant (athlete, coach, minister or spectator) 4) Not to engage in unsportsmanlike conduct such as, but not limited to, taunting, put downs, and pouting. 5) When using social media, my posts will conform to all aspects of this code of conduct. I understand that anyone who fails to conform to this Code of Conduct during any SPAA sanctioned event will be subject to disciplinary action.
Required
Permission and Medical Release *
Required
Emergency Contact Information *
If the above listed guardians cannot be reached in an emergency the following person is allowed to act on our behalf. (Please include phone number)
Your answer
Has your child had a tetanus shot in the last 10 years. *
Required
Does your child have any allergies or other medical considerations the coach needs to be aware of? *
Your answer
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