Northern Virginia United Academy
2023 ID Session Sign-up Form
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PLAYER FIRST NAME *
PLAYER LAST NAME *
YEAR OF BIRTH *
Gender *
CURRENT CLUB *
POSITION *
Required
CONTACT EMAIL ADDRESS *
CONTACT PHONE NUMBER *
MEDICAL RELEASE WAIVER
My child is in good normal health and has my permission to participate in all training activities. In addition, I authorize Northern Virginia United Academy to act for me in securing medical treatment in the case of an emergency, illness or injury. Northern Virginia United Academy assumes no responsibility and will not be held liable for any accident resulting in medical, dental, or any other expenses. Each participating child is required to carry personal medical insurance coverage and understands the risks involved in playing competitive soccer.
MEDICAL RELEASE ACCEPTANCE DECLARATION *
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