West Jersey SC & Voetbaloa Academy Soccer Camp Registration
July 29 - August 2 at Warren Hills MS field. (Camp is limited to 40 players)
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I understand that there are two parts for registering for Summer Soccer Camp.  Part one is this completing this Google Registration Form. Part two is paying in full through the PayPal link on the West Jersey SC website.  I understand that if I do not complete both steps- my player will not be fully registered for this camp and his/her spot will not be reserved. *
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Player's First and Last Name: *
Player's home address: *
Parent/Guardian - First and Last Name: *
Parent/Guardian cell phone number: *
Parent/Guardian email address: *
Secondary contact name and cell phone number for emergency in case Parent/Guardian cannot be reached. *
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Player's Height: *
Player's Weight: *
Player's Sex: *
Player's Date of Birth: *
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Player's T-shirt Size *
Player's Health Insurance Information (please include the name of the insurance company, the policy number and the subscriber's first and last name): *

I acknowledge that this Accident Waiver and Release of Liability Form will be used by West Jersey Soccer Club in which my child will participate in at this Soccer Camp. 

I certify that my child is physically fit and has not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my child's participation in this Soccer Camp. 

I agree to allow my child to be treated by a licensed physician while attending, if necessary, and to assume all costs related to such treatment. 

I acknowledge that this Soccer Camp may carry with it the potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, and lack of hydration. 

Hold Harmless Agreement- I release West Jersey Soccer Club and Voetbaloa Academy and all of their employees, volunteers, officers and agents from any liability for damages.

I consent and agree that West Jersey Soccer Club and Voetbaloa Academy, and/or their coaches, agents, representatives or volunteers may take photographs or digital recordings of my child during this event and use these in any and all media for training or promotional purposes. 

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