Steamboat Shorty’s Emergency Information Form
In order for your child to play soccer with us this summer, please fill out the following information.
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电子邮件地址 *
Child's Name *
How do you plan to pay for your $60 registration?(due on the first day or else it's a $10 additional fee for each day that payment is late)
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Due to the increase in our demand for spots in our sessions, we have a new policy: In the event you have to cancel your registration, or you don't show up, you will have to pay a fee of $30. Additionally, if you don't pay on the first day of practice, you will be charged a $10 late fee for each day you are late on payment. Please check that you understand our policy and will comply with the charges in the event you don't show or you cancel. Thanks for your understanding with this, really.
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purchasing gear
Email Address:
(For updates and Reminders)
What Option(s) are you signed up for? (Check all that apply) *
必填
What session are you signed up for? *
Child's Age *
必填
Child's Birthday *
Address: *
 Phone Number: *
List 2 people in case of emergency: *
Please include name, phone number, address and relationship to your child
What is the name and phone # of your Physician? *
Does your child have any of the following? *
Check all that apply
必填
If you checked any of the above boxes, please describe. *
Read the following liability waiver and check that you agree to all terms and conditions. Thanks! *
必填
Steamboat Shorty’s Liability Waiver
Any additional information we should know about? *
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