2021 Soccer Camp Registration
Soccer camp will be held July 27th, 28th, and 29th from 530-730pm
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Email *
Participant First Name *
Participant Last Name *
Gender *
Current Grade (for 2021-2022 school year) *
My child has played soccer: *
Shirt Size *
Does your player need cleats? ($5 add on) Please indicate size, or N/A *
Does your player need shin guards? ($3 add on) *
Does your player need a gear bag? ($5 add 0n, style/logo may differ as we are switching over suppliers and logos) *
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Parent/Guardian's Name *
Parent/Guardian Phone Number *
Emergency Contact and Phone Number *
Allergy/Medical issues, PLEASE include FOOD ALLERGIES *
Other helpful information *
My child would like to participate in
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Registration Fees (multi-player discount!) *
Payment will be sent via (registrations will not be processed until payment is received): *
Parent Volunteer Opportunities *
Please list your volunteer request below
Please type your name below, acknowledging that you agree to the following. (This will be taken as an "e-signature".) I request that you accept the registration form of this child in the Edgerton Youth Soccer Association for the dates specified on the brochure. In consideration of your acceptance of the registration, I release Edgerton Youth Soccer Association, its volunteers, coaches and the board members from all claims on the account of any injuries which may be sustained while attending the practices and games. I agree to indemnify and hold EYSA, its volunteers, coaches and board members harmless for injury and expense including costs of defense which may result from activities associated with participation in this program. If medical attention is required for injury or illness for the participant, I give my permission for such medical care and take full responsibility for payment of such medical care. I understand that volunteers will be taking pictures, and my child may be captured in images. This pictures will be used for publicity and fundraising on the EYSA website, Facebook, Twitter, and volunteer websites. *
COMMUNICABLE DISEASE RELEASE OF LIABILITY & ASSUMPTION OF RISK AGREEMENT In consideration of being allowed to participate, at the sole discretion of the Edgerton Youth Soccer Association ("EYSA"), I, the undersigned, acknowledge, appreciate, and agree that: I understand that this Waiver is an important legal document, and that I have a right to ask questions regarding this Waiver, bargain/negotiate the terms of this Waiver, and review this Waiver with an attorney. I confirm that I have carefully read this Waiver, that the terms of this Waiver are acceptable to the Participant and me, if I am signing on behalf of the participant, and that I am knowingly and voluntarily waiving any right that I or the Participant may have to bargain for different terms by signing this Waiver. I understand that if any portion of this Waiver is held to be invalid, the balance shall continue to be in full force and effect. I am aware there are risks to me of exposure directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof. Because COVID-19 is extremely contagious and is spread mainly from person-to-person contact, EYSA has put in place preventative measures to reduce the spread of COVID-19. I understand EYSA cannot guarantee that its employees, volunteers, other participants, sponsors, advertisers, or others in attendance will not become infected with COVID-19. I agree to self-monitor for signs and symptoms of COVID-19 (symptoms typically include fever, cough, and shortness of breath) and, contact EYSA if I experiences symptoms of COVID-19 within 14 days after participating at a Sanctioned Event with EYSA. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS THE EDGERTON YOUTH SOCCER ASSOCIATION, its officers, officials, agents and/or employees, other participants, volunteers, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability except for those for harm caused intentionally or recklessly, arising out of or related to any ILLNESS, INJURY, DISABILITY OR DEATH I may suffer related to participation in the Sanctioned Activities, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Participant Signature: Date: FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law *
I agree to the Edgerton Youth Soccer Association Parent/Coach Code of Conduct, as found here: http://www.edgertonsoccer.com/app/download/3342378/Parent%2BCoach%2BCode%2Bof%2BConduct.pdf *
A copy of your responses will be emailed to the address you provided.
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