2019 Hunterdon Youth Day Camp Registration
Please fill out the registration below.
LAST NAME *
Your answer
FIRST NAME *
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EMAIL ADDRESS *
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Gender
Date of Birth (MM/DD/YYYY
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CONTACT PHONE NUMBER *
Your answer
STREET ADDRESS *
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TOWN/CITY *
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STATE
ZIP CODE *
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GRADE *
Please Choose what grade your child will be entering in September 2019
Required
WAIVER *
By placing your FULL NAME as a parent/legal guardian of the child named above, electronically below you agree to the following terms. Recognizing the possibility of physical injury associated with soccer and in consideration for SoccerSmith, LLC accepting the registrant for this SoccerSmith, LLC program, I hereby release, discharge and/or otherwise indemnify SoccerSmith, LLC, and its affiliated organizations and sponsors, their employees and associated personnel, including the owner of the facilities utilized for this SoccerSmith, LLC Program against any claim by or on behalf of the registrant as a result of the registrant’s participation in this SoccerSmith, LLC program and/or being transported to or from the same, which transportation I hereby authorize. My son/daughter has received a physical examination by a physician and has been found physically capable of participating in this SoccerSmith Program. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment and agree to be responsible financially for the cost of each assistance and/or treatment.
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