form.asp

Caliph Soccer
Indoor Soccer
Winter 2007 to 2008
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REGISTRATION FORM
 
Childs Name  
Mailing Address  
City  
Zip  
Age as of 08/01/2007  
Birthday  
Guardian Name  
Home Phone  
Work Phone

 

Additional Player Information

 Number of Prior Seasons Played
 Last Team
 Last League
Date of Last Season Played
 Team Preference
 Practice Preference

 Other Children in League (please list)

 

 

 
 Any Physical Problems?
 
Waiver
Participation in a Youth Soccer Program involves certain risks.  The Caliph Soccer Club (CSC) will not assume responsibility for any injury incurred while participation in any Youth Soccer event.  Nor will the CSC be liable for lost or stolen items while members and/or program participation are using CSC facilities or are on the CSC premises.  I give permission for the CSC, without obligation to me, to use any photographs, film footage, tape recordings, which may include my and/or child's image or voice for purpose of promoting or interpreting CSC programs.  I, the undersigned for myself, my heirs and assigns, do hereby release the CSC and its branches, employees, and agents from any and all claims for injury, death, loss, or damages I may suffer as a result of participation.
 
Print Full Name
 
Digital Signature (Type Initials)
 
 
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