9 Sessions Registration 
 Welcome to LIC Youth Soccer Academy!      Please fill out the form below.

This program consist of 9 sessions of soccer classes.Children will be introduced to the basics of soccer in a fun and instructional way to be inspire for the passion of this sport. The session consist of 60 minutes practice 3x a week .Their will be one (1) make-up class. All sessions must be completed within the 3 week time frame.   Ages 5 -10 years  Girls and Boys are Welcome! 
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Email *
Player's Full Name: *
Player's Date of Birth *
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Player's Address: *
Player's Full Parent/Guardian Name: *
Contact Number : *
Date Sign Up: *
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I hereby authorize Long Island City Youth Soccer to take photographs or video footage, electronic images or movies of my child or us participating in the program and to use same in promotional or advertising materials for Long Island City Youth Soccer flyers, on the internet, and all other forms of media, and we waive any right to compensation or other rights related to such use. I acknowledge that I have read and understand and agree to all the above terms and conditions of the Long Island City Youth Soccer program. 

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Required

I understand that Long Island City Youth Soccer reserves rights to suspend or expel any player from the club for any type of in disciplinary action including excessive absences. I also understand that once player joins Long Island City Youth Soccer there will be no membership refund applicable. 

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I agree by signing below that I wave the risk of any type of injury that may occur during the games or training sessions of Long Island City Youth Soccer while I am participating. I hereby release waive discharge and covenant not to sue Long Island City Youth Soccer, its owners, promoters, sponsors, officials and employees involved in organizing this event. I also assume full responsibility for any loss, liability, death or cost that may incur due to the negligence or the result of any action by them, around or upon the playing areas while they or and/or I am competing, participating and observing working for and/or any other way associated with the event within premises. 

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9 SESSIONS ONLY: *
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