Alpharetta Ambush Player Information Parent or Guardian Information ...
Alpharetta Ambush 2012 Super Y League Registrataion PLEASE PRINT
CHECK THIS BOX IF YOU ARE TRAINING ONLY ($75.00) CHECK THIS BOX IF YOU HAVE BEEN ACCEPTED TO A TEAM ($495.00)
Player Information Player's Name
Date of Birth
Street Address
City
State
Zip Code
Player's Home Club
Uniform Information ($85.00) (Provide player's size for all 3 parts of uniform. Returning Player No Uniform Needed
New Player
Jersey Size -
Shorts Size -
Jersey # (3 options) -
Adidas Uniforms Sizes (YS, YM, YL, AS, AM, AL, AXL)
Provide 3 options for jersey number.)
Socks Size -
Shoe Size to Sock Size - 13-4.5 /Sm ♦ 5-8.5 /Med ♦ 9-13/Large
Parent or Guardian Information Parent 1
Parent 2
Cell Phone
Cell Phone
E-mail
E-mail
Liability Waiver In consideration of the Alpharetta Ambush Soccer Club, by participating in the 2011 Alpharetta Ambush Super Y League program, I agree as follows. I am the legal parent/guardian of the above named participant. In case of medical emergency, I understand that the Alpharetta Ambush Soccer Club will attempt to contact a family member at the telephone number listed. If they cannot be reached, I hereby give my permission to the Alpharetta Ambush Soccer Club to secure medical treatment for my child/legal guardian. I understnad that the person participating in the Alpharetta Ambush Soccer Club and/or family members assumes all risk of loss of property or injury to the person, including injury resulting in death caused by or incidental dangers associated with soccer activities and agree that there are certain inherent dangers relating to soccer participation and therefore agree to hold the Alpharetta Ambush Soccer Club and owners, officers, coaches, managers, employees, facilities, sponsors, partners, and agents of the foregoing, harmless and specifically agree not to make any claim against the Alpharetta Ambush Soccer Club or its partners or sponsors for any injuries or loss. I acknowledge that the Alpharetta Ambush Soccer Club carries no insurance for players beyond club liability insurance and that I am free to seek individual insurance from an independent insurance agent.
I have read and accept the terms of liability waiver and give permission for my child to participate in the above named program. Signed: Parent/Guardian) Print Name: Date: Relationship to Player:
CHECK THIS BOX IF YOU ARE TRAINING ONLY ($75.00) CHECK THIS BOX IF YOU HAVE BEEN ACCEPTED TO A TEAM ($495.00)
Player Information Player's Name
Date of Birth
Street Address
City
State
Zip Code
Player's Home Club
Uniform Information ($85.00) (Provide player's size for all 3 parts of uniform. Returning Player No Uniform Needed
New Player
Jersey Size -
Shorts Size -
Jersey # (3 options) -
Adidas Uniforms Sizes (YS, YM, YL, AS, AM, AL, AXL)
Provide 3 options for jersey number.)
Socks Size -
Shoe Size to Sock Size - 13-4.5 /Sm ♦ 5-8.5 /Med ♦ 9-13/Large
Parent or Guardian Information Parent 1
Parent 2
Cell Phone
Cell Phone
Liability Waiver In consideration of the Alpharetta Ambush Soccer Club, by participating in the 2011 Alpharetta Ambush Super Y League program, I agree as follows. I am the legal parent/guardian of the above named participant. In case of medical emergency, I understand that the Alpharetta Ambush Soccer Club will attempt to contact a family member at the telephone number listed. If they cannot be reached, I hereby give my permission to the Alpharetta Ambush Soccer Club to secure medical treatment for my child/legal guardian. I understnad that the person participating in the Alpharetta Ambush Soccer Club and/or family members assumes all risk of loss of property or injury to the person, including injury resulting in death caused by or incidental dangers associated with soccer activities and agree that there are certain inherent dangers relating to soccer participation and therefore agree to hold the Alpharetta Ambush Soccer Club and owners, officers, coaches, managers, employees, facilities, sponsors, partners, and agents of the foregoing, harmless and specifically agree not to make any claim against the Alpharetta Ambush Soccer Club or its partners or sponsors for any injuries or loss. I acknowledge that the Alpharetta Ambush Soccer Club carries no insurance for players beyond club liability insurance and that I am free to seek individual insurance from an independent insurance agent.
I have read and accept the terms of liability waiver and give permission for my child to participate in the above named program. Signed: Parent/Guardian) Print Name: Date: Relationship to Player:
