International Soccer Programs Inc.

International Soccer Programs Inc. 2015 – 2016 Soccer Residency Boarding Application The Schulz Soccer Academy, located in beautiful Boca Raton and Coral Springs, Florida, is pleased to announce the new 2015 - 2016 Soccer Residency Boarding Program for serious youth soccer players. This program will focus on developing the youth player, boys U14-U19, during the year, and provide a fantastic setting for working on individual skills, technique, and conditioning. The Soccer Boarding Program will be led by Head Coach Roland Kollmann with UEFA A License “We have a great group of youth soccer players here in South Florida and through our residency program we can provide the level of training they need to keep them playing at a high level. Many of our players plan to play in college and even professionally. This program will allow them to prepare for the season, college soccer tryouts, and professional tryouts both here in the states and abroad.” Last Name ___________________________ First Name______________________ Nickname ________________ Date of Birth ______________ Age _______ Grade/Year ________ School_________________________________ Address _________________________________City __________________ State____ Zip _____________ Parent/Guardian _________________________ Home Number ______________ Mother’Cell ________________ Father’s Cell________________________ Email________________________ Size Uniform : S M L XL Start:_________________________ End_______________________________ Price per Month:______________________ ( monthly payment is due latest on the first of the month, one month deposit) Emergency Contacts: 1.) Name _____________________________________ Phone _________________________________ 2.) Name _____________________________________ Phone _________________________________ Liability Release and Indemnity Agreement: I hereby request that you accept this application for enrollment in the Schulz Academy 2015 -2016 Soccer Residency Boarding Program during the dates set forth in this application. I hereby release Roland Kollmann, Schulz Academy and employees from all participant claims on account of any injuries which may be sustained by me while attending the Program, and I agree to indemnify the Schulz Academy, its employees, coaches, and agents for any claim which may hereafter be presented by me as a result of any such injuries. Parent/Guardian Signature:_________________________________ Date ___________________ How did you hear about us? ____________________________________________________________________ Medical Certification: I hereby certify that _____________________ is physically fit to participate in an active soccer camp during the summer months of the camp for which he has registered. I know of no physical impairments which would in any manner limit his participation in such a program. Please describe your child’s current medical conditions (Asthma, Allergies,) _____________________________ Medications Currently Taking:__________________________________________________________________

Parents Signature: _________________________________________________ Date: ___________________