CPS Soccer Academy Sign Up Form (MURFREESBORO LOCATION)

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Email *

Name *

Age *

Position *

Do you have any past playing experience? *

Yes

Required

If yes, where? *

What location are you signing up for? *

MURFREESBORO

Gender *

T-shirt size *

Shorts size *

Address *

City *

Home Phone *

Cell Phone *

Father`s Name *

Mother`s Name *

Email *

Contact in case of an emergency? *

Emergency contact number *

Were you recommended by someone? If so, who? *

How did you hear about us? *

I hereby give my permission for CPS Soccer Academy/CPS Soccer Camps staff to provide any needed medical treatment for my son/daughter while he/she is attending the sports camp/trainings. I specifically, give my permission for necessary and emergency care to be given to my child by the nearest hospital and any other medical treatment providers. I attest that my son/daughter has had a physical within the last twelve months and that the physical disclosed no medical conditions, other than those listed in the registration form, that would make participation in this sports camp/training a risk. I hereby acknowledge that participation in this sports camp and related activities is at the sole discretion and judgment of the parent or guardian and involves an inherent risk of personal injury. I, on behalf of my son/daughter, hereby assume all such risk. I hereby release and agree to hold harmless CPS Soccer Academy/CPS Soccer Camps and its employees from all claims, actions, damages and liabilities for personal injury or damage relating to or arising out of any sports camp activity. *

Please read the following waivers and agreements carefully. They include release of liability and waiver of legal rights, and deprive you of the ability to sue certain parties. By agreeing electronically (clicking this button), you acknowledge that you have both read and understood all text presented to you as part of the registration process.

I, the parent or legal guardian of a child participating in CPS Soccer Academy/CPS Soccer Camps, hereby authorize CPS Soccer Academy/CPS Soccer Camps and those acting pursuant to its authority to: (a) Record my child’s likeness and voice on a video, audio, photographic, digital, electronic or any other medium; (b) Use my child’s name in connection with these recordings; (c) Use, reproduce, exhibit or distribute in any form (e.g. print publications, video tapes, CD-ROM, Internet/WWW or any other form now or hereafter developed) these recordings for any purpose that CPS Soccer Academy/CPS Soccer Camps, and those acting pursuant to its authority, deem appropriate, including promotional or advertising purposes. I understand that all such recordings, in whatever medium, shall remain the property of CPS Soccer Academy/CPS Soccer Camps. *

Please read the following waivers and agreements carefully. They include Photographic Release Form, and deprive you of the ability to sue certain parties. By agreeing electronically (clicking this button), you acknowledge that you have both read and understood all text presented to you as part of the registration process.

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