FC DELCO Boys Goalkeeper - 2009 & 2010 Talent ID Clinic Non Registered Player Registration & Waiver
This form is for the January 28, 2023 Boys GK Clinic for 2009 and 2010 to take place at the Proving Grounds at Field #1

To be filled out by a non-minor player or the  parent or guardian of a minor player
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Player First Name *
Player Last Name *
Player Birth Date *
Player Age: *
Parent First Name (if player is a minor) *
Parent Last Name (if player is a minor) *
Email Address (Or parent email address if player is a minor) *
Phone (Or parent phone if player is a minor) *
Emergency Contact *
Emergency Contact Phone Number *
APPROVAL AND MEDICAL RELEASE Recognizing the possibility of physical injury, I, the above-named player OR parent/guardian of the above-named player, a minor, do hereby release, discharge and/or otherwise indemnify the Continental FC and its affiliated organizations including, without limitation, FC DELCO and Spirit United SC, and their respective officers, coaches, referees, managers, board members, tournament hosts and their officials, employees and associated personnel, including the owners of the fields and facilities utilized for the Programs ("Programs," as used herein, means games, tournaments, clinics, practices, and/or soccer activities or social events organized by Continental FC or its affiliated organizations), against any and all claims by or on behalf of the above-named player as a result of such player's participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize by the officer, coach or agent(s) of the Continental FC. The above-named player has received a physical examination by a physician and has been found physically capable of participating in the Programs. I, the above-named player OR the parent/legal guardian of the above-named player, hereby give my consent to have an athletic trainer, doctor of medicine or dentistry, or other medical professional provide the above-named player with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of such assistance and/or treatment. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of the above-named player. *
Please Print Your Full Name as Your Signature: *
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