Path to Victory Soccer Camp Registration
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Child's Name *
(First and Last)
Gender
Clear selection
Grade (Fall of '13)
Clear selection
Shirt Size
Clear selection
Address
City, State, Zip
Parents' Names *
Home Phone Number
Cell Phone
(Separated by a comma)
Email
(Separated by a comma)
Other Emergency Contact Information
(Another person and/or number)
Allergies and/or Concerns
Consent *
My child desires to participate in the soccer camp on July 15-18, 2013 located at Kenai Sports Complex.  The parent/guardian listed above acknowledges that there are dangers and risks of injury inherent in sports activities, but still allows his/her child to participate in said activities. THEREFORE, the undersigned, for and in consideration of the opportunity to participate in the Path to Victory Soccer Camp and for other good and valuable consideration, does hereby accept full responsibility for liability and cost of treatment of injury to the above registered person. The undersigned does hereby release the coaches/assistants and Grace Lutheran Church and School from all liability resulting from negligence and agrees to hold them harmless for any injuries and/or damages his/her child may sustain arising out of the activities inherent in a soccer camp.  The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned, and that this release contains the entire agreement between the parties hereto, and that the terms of this release are contractual in nature and are not a mere recital.
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