Futsal Registration
PO BOX 6182 Aurora, Il 60598 (630) 201-0948 [email protected]
Futsal Registration Boys and Girls Player Name:_____________________ DOB _____________ Age _____ Grade ______ Boy ( ) Girl ( ) Address ____________________________ City ________________ Zip _________ Mother Name: _____________________________ Mother Cell # _______________ Father Name: ______________________________Father Cell # _______________ Emergency Contact: ________________________________________ Parents Primary E-Mail: _____________________________________________________________ By signing below; My child is cleared by a physician to participate in any physical activity required during training. I hereby give permission and certify my child is in good health and able to participate in all soccer activities, I release the coaches, staff, selects to run training sessions, and all others associated with DiDi’s Soccer Academy independent contractors that is from any and all responsibility/liability of physical injury that may be incurred by my child due to participation in the training program. I understand that photographs, recording taken at this program may be used in DiDi’s Soccer Academy advertising with no compensation, financial or otherwise.
PARENT’S SIGNATURE ________________________ DATE ______________________
Futsal Registration Boys and Girls Player Name:_____________________ DOB _____________ Age _____ Grade ______ Boy ( ) Girl ( ) Address ____________________________ City ________________ Zip _________ Mother Name: _____________________________ Mother Cell # _______________ Father Name: ______________________________Father Cell # _______________ Emergency Contact: ________________________________________ Parents Primary E-Mail: _____________________________________________________________ By signing below; My child is cleared by a physician to participate in any physical activity required during training. I hereby give permission and certify my child is in good health and able to participate in all soccer activities, I release the coaches, staff, selects to run training sessions, and all others associated with DiDi’s Soccer Academy independent contractors that is from any and all responsibility/liability of physical injury that may be incurred by my child due to participation in the training program. I understand that photographs, recording taken at this program may be used in DiDi’s Soccer Academy advertising with no compensation, financial or otherwise.
PARENT’S SIGNATURE ________________________ DATE ______________________
