eagle football camp
ELEMENTARY TOTAL SOCCER REGISTRATION 2017 WHO: Any Parkway Christian boy or girl in grades 1, 2, 3, 4,5 WHERE: Total Soccer, 34300 Utica Fraser, MI 48026 Phone: (586) 294-8848 SUPERVISION: We are currently looking for parents interested in coaching. GRADES: Grade 1 & 2 Team, Grade 3 &4 Team, Grade 5 Team (Teams are Co-Ed) BRING: Soccer Cleats (Tennis Shoes for Gym Practice) Shin Guards, Shorts. WHEN: The Fall Season will begin Friday, October 28th for 1st – 2nd Grade, and Monday, October 23rd for 3rd – 4th and 5th grade. The season run to mid-December.
Registration deadline is September 22nd. Teams will be made up of the first 12 boys/girls that register per team (Grades 1&2, Grades 3&4, Grade 5) COST: $105 Please send in your registration to the office. Please make out Checks to: Parkway Christian. QUESTIONS:
Tom Kocik, A.D. – 586 446-9900
***Each player must have the Parkway Christian Release and Waiver form filled out and signed by a parent or a guardian in order to participate in Elementary Soccer. ***For student’s safety each player should have a physical form on file with Parkway Christian in order to participate. *** Practices will be on Saturday afternoons beginning the first weekend in October
--------------------------------------------------------------------------------------------------------------------------------STUDENT’S NAME __________________________________________________________________ PARENT/GUARDIAN (PLEASE PRINT):_________________________________________________ ADDRESS:____________________________________________ ______________________, MI (ZIP)______________________________ PLAYER ENROLLED IN WHAT GRADE: 1 2 3 4 5 PHONE NUMBER_____________________ SHIRT SIZE: YS YM YL AS AM AL PARENT SIGNATURE:___________________________________________
FULL WAIVER, RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT Activity or event: Parkway Christian’s Elementary Total Soccer Team Child/children’s names(s): 1) ___________________________________ (Please print all names legibly) 2) ___________________________________ 3) ___________________________________ By allowing the listed child (“Participant”) to participate in this event I acknowledge and understand: There are certain inherent risks and dangers the child may encounter while traveling to, participating in, or returning from this event, that could result in injury (whether physical, mental, social, economic or emotional), death or some type of property loss. There may not be any or sufficient insurance provided by Bethesda Christian Church and/or Parkway Christian School (“Bethesda”) for any type of injury, property loss or other damages that may occur and I have signed this document without regard to whether Bethesda has insurance or maintains sufficient insurance for any type of claim, damage or loss. I agree to assume any and all risks and hazards of injury or loss arising out of or in the course of the listed event without regard to whether the risk or danger was reasonable and/or foreseeable by Bethesda. On behalf of any assignees, and myself, I release and hold Bethesda harmless from any and all liability and expense, including litigation costs and attorney fees arising out of any and all claims that I may have or later assert. In addition, I hereby waive all claims I may have against Bethesda, or any of its trustees, officers, employees, representatives, agents and volunteers (Bethesda affiliates). I shall hold harmless and indemnify Bethesda and Bethesda affiliates from any and all claims, liabilities and expenses arising out of claims brought by third parties in connection with any acts or omissions of the Participant. The laws of the State of Michigan shall govern this Agreement. I understand and acknowledge I have the option of not applying to allow the child to participate in the listed event, and of not becoming involved in the listed event if the terms and conditions listed above are not acceptable. I HAVE READ THE TERMS OF THIS AGREEMENT, UNDERSTOOD THIS DOCUMENT AND, BY SIGNING MY NAME, FREELY, FULLY AND VOLUNTARILY AGREE TO THE SAME AS BINDING UPON ME, MY HEIRS, NEXT OF KIN AND/OR PERSONAL REPRESENTATIVES.
Dated this ____________ day of ___________________________, 20____
____________________________________________________________________________ Parent/Legal Guardian ____________________________________________________________________________ Parent/Legal Guardian
Registration deadline is September 22nd. Teams will be made up of the first 12 boys/girls that register per team (Grades 1&2, Grades 3&4, Grade 5) COST: $105 Please send in your registration to the office. Please make out Checks to: Parkway Christian. QUESTIONS:
Tom Kocik, A.D. – 586 446-9900
***Each player must have the Parkway Christian Release and Waiver form filled out and signed by a parent or a guardian in order to participate in Elementary Soccer. ***For student’s safety each player should have a physical form on file with Parkway Christian in order to participate. *** Practices will be on Saturday afternoons beginning the first weekend in October
--------------------------------------------------------------------------------------------------------------------------------STUDENT’S NAME __________________________________________________________________ PARENT/GUARDIAN (PLEASE PRINT):_________________________________________________ ADDRESS:____________________________________________ ______________________, MI (ZIP)______________________________ PLAYER ENROLLED IN WHAT GRADE: 1 2 3 4 5 PHONE NUMBER_____________________ SHIRT SIZE: YS YM YL AS AM AL PARENT SIGNATURE:___________________________________________
FULL WAIVER, RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT Activity or event: Parkway Christian’s Elementary Total Soccer Team Child/children’s names(s): 1) ___________________________________ (Please print all names legibly) 2) ___________________________________ 3) ___________________________________ By allowing the listed child (“Participant”) to participate in this event I acknowledge and understand: There are certain inherent risks and dangers the child may encounter while traveling to, participating in, or returning from this event, that could result in injury (whether physical, mental, social, economic or emotional), death or some type of property loss. There may not be any or sufficient insurance provided by Bethesda Christian Church and/or Parkway Christian School (“Bethesda”) for any type of injury, property loss or other damages that may occur and I have signed this document without regard to whether Bethesda has insurance or maintains sufficient insurance for any type of claim, damage or loss. I agree to assume any and all risks and hazards of injury or loss arising out of or in the course of the listed event without regard to whether the risk or danger was reasonable and/or foreseeable by Bethesda. On behalf of any assignees, and myself, I release and hold Bethesda harmless from any and all liability and expense, including litigation costs and attorney fees arising out of any and all claims that I may have or later assert. In addition, I hereby waive all claims I may have against Bethesda, or any of its trustees, officers, employees, representatives, agents and volunteers (Bethesda affiliates). I shall hold harmless and indemnify Bethesda and Bethesda affiliates from any and all claims, liabilities and expenses arising out of claims brought by third parties in connection with any acts or omissions of the Participant. The laws of the State of Michigan shall govern this Agreement. I understand and acknowledge I have the option of not applying to allow the child to participate in the listed event, and of not becoming involved in the listed event if the terms and conditions listed above are not acceptable. I HAVE READ THE TERMS OF THIS AGREEMENT, UNDERSTOOD THIS DOCUMENT AND, BY SIGNING MY NAME, FREELY, FULLY AND VOLUNTARILY AGREE TO THE SAME AS BINDING UPON ME, MY HEIRS, NEXT OF KIN AND/OR PERSONAL REPRESENTATIVES.
Dated this ____________ day of ___________________________, 20____
____________________________________________________________________________ Parent/Legal Guardian ____________________________________________________________________________ Parent/Legal Guardian
