San Jose Kicks For Kids Player Registration Form (2018-2019)
Thank you so much for your interest in participating in San Jose Kicks for Kids! We look forward to having you joining us on the field soon. Please read the following information and complete the registration form below*.

Mark your calendars with our Spring 2019 Season dates:
March 3, March 10, March 17, March 24, March 31

All events take place at Gunderson High School in San Jose, California. You will receive more information via email during the week leading up to each event.

*PLEASE NOTE: If you registered for our Fall 2018 Season, you WILL NOT need to complete another registration form to participate in the Spring 2019 Season. Your registration from Fall 2018 is effective through the last session of the Spring 2019 Season. If you are unsure about your registration status, please email us at sanjosekfk@gmail.com and we would be happy to confirm it for you!

**IMPORTANT: All Kicks for Kids communication is conducted via email. The organization will send all details and updates (including any potential cancellations) to the email address that you list below, so please be sure to check the listed email address frequently.

If you have any questions, please email us at sanjosekfk@gmail.com.

Email address *
Participant First Name: *
Your answer
Participant Last Name: *
Your answer
Age of Participant: *
Your answer
Sex: *
T-Shirt Size: *
While we will do our very best to accommodate your size preference, please understand that the sizes are on a first come, first serve basis, and our supply is limited. Only one shirt will be given per participant. If your participant has attended Kicks for Kids before, we ask that you please bring your old shirt so that we can provide as many people with shirts as possible.
Participant's Communication Ability: *
Participant's Primary Spoken Language(s): *
If "Other" is selected, please list the primary spoken language in the "Additional Information" box
Parent/Guardian Name: *
Your answer
Phone Number: *
Your answer
Emergency Contact: *
Other Contact:
(If "Other" was selected above)
Your answer
Please list all medical/physical disabilities of participant: *
Your answer
Please list any and all special dietary needs/restrictions: *
Your answer
Will you allow your child's photo and/or video to be taken in collaboration with Kicks for Kids? *
By selecting yes, you understand that the images may be for promotional purposes and may be used on platforms such as, but not limited to, print publications, online publications, presentations, websites, and social media. You also understand that no royalty, fee, or other compensation shall be made payable to you by reason of such use. Pictures and/or videos will generally be made available on our Facebook page if you would like to view them.
How Did You Hear About Us?
Your answer
Additional Information:
Optional -- Please list anything else you would like for us to know.
Your answer
LIABILITY RELEASE: Gunderson High School sponsors various programs for students, staff, faculty and members of our community. In supporting such programs, the school may make certain facilities, services, and personnel available to the participants. However, the school assumes no responsibility for any injury or damage suffered by a participant in connection with the use of such facilities or services. Further, the school assumes no responsibility for any injury or damage suffered by a participant while traveling to and from the event. IN CONSIDERATION OF THE SCHOOL PROVIDING THE FACILITIES, SERVICES AND PERSONNEL AND IN CONSIDERATION FOR THE CONTINUATION OF SUCH ACTIVITIES, THE UNDERSIGNED RELEASES GUNDERSON HIGH SCHOOL AND ITS PERSONNEL IN ANY CAPACITY FROM ANY AND ALL LIABILITY AND RESPONSIBILITY FOR INJURY OR DAMAGES WHICH MAY BE INCURRED BY THE UNDERSIGNED FROM PARTICIPATION IN SUCH ACTIVITIES. The undersigned further agrees to conform to all rules and regulations adopted by Kicks for Kids relating to the activities at Gunderson High School. *
Please electronically sign this liability release by typing your full first and last name below. (Must be signed by parent/guardian if participant is under 18)
Your answer
Date Signed: *
Your answer
A copy of your responses will be emailed to the address you provided.
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