REGISTRATION FORM
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Email *
Welcome to the Bolts Family, an ELITE soccer club serving the Boston area since 2002.
For what program are you registering for ? *
Please list any medical issues or any disabilities the player has. If none, respond with "NONE." *
As a club we do not have members on the staff who have specialized training or certifications to teach kids who have special learning needs.  Please mark that you are aware of this. *
Required
I warrant the Revere FC that the player is physically in healthy conditions to fully participate in soccer activities. *
Does the player have any specific allergies? If yes, please describe:
DISCLAIMER, ASSUMPTION OF RISK AND WAIVER:  The parent or guardian of the registrant, a minor, agrees that I and the registrant will abide by the rules of US Soccer, MYSA, Revere Futbol Club, FC Boston Bolts, and its affiliated organizations and sponsors. Recognizing that there is the possibility of physical injury associated with soccer in consideration of Revere FC accepting the registrant to its soccer programs and activities. I agree that I will not sue FC Boston Bolts or its associates and I release Revere FC from any liabilities, claims, demands, actions, and costs as consequences of my involvement in the program. I further agree that my child, my family, my friends, and I will abide by the Revere FC code of conduct and that any violation could result in my player's dismissal from the program. The Revere FC code of conduct applies to players, parents, family, or friends of the player. *
I grant permission to the Revere FC staff to apply emergency medical treatment if it is deemed appropriate. *
Did the child previously play in a competitive league? *
If yes, which Club or League did the child play in before?
Player's First Name *
Player's Last Name *
Gender: *
Date of Birth: *
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Home Address: *
Parent 1 - Full Name: *
Parent 1 - Email: *
Parent 1 - Cell Number: *
Parent 2 - Full Name:
Parent 2 - Email:
Parent 2 - Cell Number:
Emergency Contact - Full Name *
Emergency Contact - Cell Number: *
PAYMENT:  You can make your payment if you click on the link.
1. To pay online  - CLICK HERE TO MAKE A PAYMENT

2. If you're going to pay with Venmo or Zelle, please leave a note stating: "Spring Bolts Clinic, Player's Full Name, Player's Date of Birth"
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