Long Island City Youth Soccer Academy Registration Form-Travel
*No Refunds
Sign in to Google to save your progress. Learn more
Email *
Player's First Name *
Player's Last Name *
Player's date of birth *
MM
/
DD
/
YYYY
Address: *
City, State, Zip *
Telephone number: *
Email address: *
Parent/Guardian's First Name: *
Parent/Guardian's Last Name: *
Please Check the program you are registering for: *
Required
Yearly membership valid from date: *
MM
/
DD
/
YYYY
Consent to photograph, film, or videotape: I hereby authorize Long Island City Youth Soccer to take photographs or video footage, electronic images or movies of my child or us participating in the program and to use same in promotional or advertising materials for Long Island City Youth Soccer flyers, on the internet, and all other forms of media, and we waive any right to compensation or other rights related to such use. I acknowledge that I have read and understand and agree to all of the above terms and conditions of the Long Island City Youth Soccer program.                                                                                                                           *
Required
RELEASE OF LIABILITY: I agree by signing below that I wave the risk of any type of injury that may occur during the games or training sessions of Long Island City Youth Soccer while I am participating. I hereby release waive discharge and covenant not to sue Long Island City Youth Soccer, its owners, promoters, sponsors, officials and employees involved in organizing this event. I also assume full responsibility for any loss, liability, death or cost that may incur due to the negligence or the result of any action by them, around or upon the playing areas while they or and/or I am competing, participating and observing working for and/or any other way associated with  the event within premises. *
Required
I understand that Long Island City Youth Soccer reserves rights to suspend or expel any player from the club for any type of in disciplinary action including excessive absences. I also understand that once player joins Long Island City Youth Soccer there will be no membership refund applicable. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms