2019 UA Summer Soccer Camp - June 17-20
Registration Form
Email address *
Player First Name *
Player Last Name *
Grade, Fall 2019 *
Player Shirt Size *
Address *
City, State *
Zip Code *
Legal Guardian *
Phone #
Emergency Contact *
Emergency Contact Phone # *
Preferred Contact Method *
Referred by
As legal guardian, I give my permission for the participant listed above to attend the 2019 UA Boys Soccer Camp. The participant is physically capable of participating in all activities without restriction. I release, hold harmless, indemnify and forever discharge UA Boys Soccer Association, coaches, staff, directors, agents, employees, and assigns from any and all liability, claims, judgements, demands or damages arising out or in connection with bodily injuries, sustained by the participation in the 2019 UA Boys Soccer Camp. I understand this activity is not sponsored by Upper Arlington City School District. I understand that the camp does not provide insurance and I am solely responsible for any financial obligations which might be incurred as a result of injuries related to the camp. I authorize Camp Staff to request medical treatment as may be deemed reasonable to insure the well-being of the participant.
I have read the above disclaimer and agree to the terms therein. Please enter full name below. *
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