Registration | Summit FC

Saturday Morning Indoor Soccer 2023

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Player Information

Player Name*

First Last

Phone*

Email*

Enter Email Confirm Email

Date of Birth*

Gender*

Grade This Fall*

Age*

School*

T-Shirt Size*

Youth Small

Youth Medium

Youth Large

Youth XL

Parent Contact Info

Parent Name*

Email Address*

Mobile Phone*

Emergency Contact Info

Name*

Home Phone*

Mobile Phone*

Medical Information

Athlete Waiver/Release Form*

I agree to the waiver.

Recognizing the possibility of physical injury associated with soccer and in consideration for Summit FC and it’s affiliates accepting the registrant for its soccer programs and activities (the “Programs”) I hereby release, discharge and/or otherwise indemnify Summit FC it’s affiliated organizations and sponsors, their coaches, employees and associated personnel, including the owners of fields and facilities utilized for the Programs, against any claim by or on behalf of the registrant’s participation in the Programs, and/or being transported to or from the same, which transportation I hereby authorize. My child has received a physical examination by a physician and has been found physically capable of participating in the Programs.

COVID Symptoms Agreement*

I agree.

I agree to NOT send my child if she/he is showing signs of illness or COVID-19 such as:
Fever
Cough
Chills
Shortness of breath
Difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

Fall Saturday Soccer Registration Fee*

Price:

Total

Billing Address*

Street Address Address Line 2 City State ZIP Code

Credit Card

Card Details

Cardholder Name

I'm not a robot

Comments

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