Madina Boys Soccer Registration
**READ THIS FIRST** Registration & participation in Madina Youth Soccer is FREE, but each player is responsible to bring their own gear to each practice: cleats, soccer socks, shin guards, water bottle & soccer ball (ages 9-11 use Size 4; ages 12-14 use Size 5 ball). Parents are responsible for TIMELY drop-off & pick-up of their child to soccer practice, at Club Drive Park (Duluth). WAIVER/DISCLAIMER: By registering my child, I hereby acknowledge that Madina Institute, its volunteers & employees are not legally liable for any loss, harm or injury that may happen my child or his property. I am registering my child for the soccer program at our own risk.
Full name of child
Child's Cell Phone Number (Optional)
Age (as of March 3, 2019)
Date of Birth
Does your child have any allergies, health concerns or physical limitations that we should be aware of? Please list any medication that may need to be administered, e.g. asthma inhaler, etc.
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