Registration form for Spring 2018: Home school soccer at the Houston Dutch Lions FC
Please fill out all the questions, if you are signing up multiple children, please make sure to all their name, positions as well as Date of Birth in the form below.

Contact Technical Director Marco Pruis at m.pruis@hdlfc.com or 936-271-0726 if you have any additional questions.

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By signing this document, you agree with the following Release and Liability Waiver:

In recognition of, and with knowledge of, the fact that engaging in the sport of soccer involves a substantial risk of personal injury, I, the undersigned, warrant that my child is in good physical condition and hereby agree to assume the risk of any injury my child suffer as a result of my participation in soccer practices for the
Houston Dutch Lions FC LLC held in January, February, March & April of 2018.

Therefore, in consideration for being permitted to participate at such soccer practices, I hereby release, waive, and forever discharge the Houston Dutch Lions FC LLC, its staff, representatives, and medical personnel from any and every claim, demand or actions of whatever kind, arising from any bodily harm, personal injury or death resulting from any accident which may occur as a result of participation in soccer practices. Further, and to the same extent and scope, I release said parties from any claim whatsoever which may be attributable to the receipt of first aid or other emergency treatment rendered me in connection with my child's participation in such soccer practice.

Pictures, Movies and/or any other kind of materials can be used for promotion or advertising purposes.

I, the undersigned, affirmatively swear that I am, at the time of signing, of legal age and legal guardian, and fully competent to and do hereby execute this Release and Waiver on behalf of heirs, my assigns, or myself. I further represent and warrant that I have read and fully understand the terms of this document and their legal significance.
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Email address *
Home school soccer back in the spring of 2018!
Name player(s): *
Your answer
Date of Birth player(s) *
Your answer
Position(s) in the field *
Required
Email address parent *
Your answer
Address *
Your answer
Phone number
Your answer
Printed name parent
Your answer
Please complete the registration by contacting the Dutch Lions FC regarding payment: m.pruis@hdlfc.com or make your payment here: https://squareup.com/store/houston-dutch-lions-fc-llc-2/item/home-school-soccer
Your answer
A copy of your responses will be emailed to the address you provided.
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