2019/2020 XL/Exploris Soccer Survey
Survey (this form), waiver (in this form), and payment all due by Wednesday, December 11. Please make sure all checks get to Shannon Hardy in 8th grade.
Email address *
Student Name
Your answer
Student Email
Your answer
Student Cell Phone
Your answer
Parent Name
Your answer
Parent Email
Your answer
Parent Cell Phone
Your answer
Players Skill Level
Please share any health or behavioral concerns you may have.
Your answer
Player's Shirt Size
I will turn in the $90 registration payment by Wednesday, December 11. *
Waiver - XL Soccerworld Waiver - By enrolling myself or my child at XL Soccer World understand that I/he/she attending any soccer program and using the facilities do(es) so at my his/her own risk. XL Soccer World and its owners, employees and agents shall not be liable for any damage whatsoever arising from any personal injury or property loss sustained by myself or my family in or about any programs on the premises.I assume full responsibility for all injuries and damages which may occur in or about any premises and I do hereby fully and forever release, discharge and hold harmless XL Soccer World, all associated facilities, and its owners, employees, and agents from any and all claims, demands, damages, rights of action, present or future resulting from or arising out of any person’s participation in any programs or use of its facilities.Consent—I hereby grant the staff of XL Soccer World the authority to render judgment concerning medical assistance or hospital care in the event of an accident or illness.
My child will participate in the one-time optional practice, at XL Soccerworld, Wednesday, December 18 from 4-5 pm. I will arrange transportation for my child to be picked up at at XL Soccerworld. (We will coordinate transportation to the practice from Exploris.)
I can drive from school (3:30 pm) to XL Soccerworld for the optional 12/18 practice. Name of Driver (# of seatbelts)
Your answer
I can coach. Parent name.
Your answer
Coach's Shirt Size
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