High School Age Free Play No Pay Early Out RSVPs
Player First and Last Name *
Your answer
Player Gender *
Player Date of Birth *
MM
/
DD
/
YYYY
Are you a current registered VSA Player (recreational or classic)? *
Email We Can Communicate Cancellations With *
Your answer
First and Last Name of Parent/Emergency Contact *
Your answer
Cell Phone of Parent/Emergency Contact *
Your answer
Email of Parent/Emergency Contact *
Your answer
Which Dates Will You Be Attending *
Required
As parent/guardian of the above child, I acknowledge that there is risk of injury with all recreation, and in consideration of said child being allowed to participate in the Vision Soccer Academy of Waukee Program, I assume all risk of injury to the child and hereby agree to indemnify and hold harmless the Vision Soccer Academy of Waukee , the Waukee Community Schools, the City of Waukee, Iowa, and the agents, servants, and employees for each of them from any claims, demands, or liability arising out of said child's participation in the Vision Soccer Academy of Waukee. *
Full Name of Parent/Guardian Filling Out Form *
Your answer
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