Professional Documents
Culture Documents
2014 SpringClinic Reg Form
2014 SpringClinic Reg Form
Players Name_______________________________ Birth Date ___________ Sex __________ Street___________________________ City__________________ CT ZIP____________________ Home Telephone____________________ E-mail Address ________________________________ athers Name_______________________________ B!siness " Cell Phone__________________ #others Name_______________________________ B!siness " Cell Phone__________________
Please check: Dad____ or #om____ $ill assist trainers %y o&erseein' a 'ro!p o( players d!rin' ea)h session*
Regis ra ion !ee: +,-*-"e#re Sorr$% &u regis ra ion fees are non ' refunda&le Please (ake checks pa$a&le o Oxford Soccer League )ail o: Oxford Soccer League P*O* +ox ,-, Oxford% C. 0/401 222*oxfordsoccerleague*ne
L34+3L3.5 R6L64S6 478 CO7S67. !OR )683C4L .R64.)67. 9)37OR: I. the parent"'!ardian o( the re'istrant. a minor. a'ree that the re'istrant and I $ill a%ide %y the r!les o( the /S0S and 1x(ord So))er 2ea'!e 31S24. its a((iliated or'ani5ations and sponsors* 6e)o'ni5in' the possi%ility o( physi)al in7!ry asso)iated $ith so))er and in )onsideration (or the /S0SA a))eptin' the re'istrant (or its so))er pro'rams and a)ti&ities. I here%y release. dis)har'e and"or other$ise indemni(y the /S0S. its a((iliated or'ani5ation and sponsors. their employees. and asso)iated personnel. in)l!din' the o$ners o( (ields and (a)ilities !tili5ed (or pro'rams. a'ainst any )laim %y or on %ehal( o( the re'istrant as a res!lt o( the re'istrant8s parti)ipation in the pro'rams and"or %ein' transported to or (rom the same. $hi)h transportation I here%y a!thori5e* As the parent or le'al '!ardian o( the a%o&e named player. I here%y 'i&e )onsent (or medi)al )are pres)ri%ed %y a d!ly li)ensed Do)tor o( #edi)ine or Do)tor o( Dentistry* This )are may %e 'i&en !nder $hate&er )onditions are ne)essary to preser&e the li(e. lim%. or $ell-%ein' o( my dependent* I a'ree $ith all the a%o&e in(ormation* Paren ;<uardian 3please print name49 _______________________________________________ 8a e: _____________ Signa ure: _______________________________________________________________________________________
)ues ions can be $irec e$ o *enni%er Mah"oo$, +,- Dir. o% Player Develo!"en /*enni%er0crnra$io.co" 1