REGISTRATION

Welcome to Champions!

The registration form is used for soccer clinics, camps, and seasons.

*Multi family member discount: two children - 10% off total; three or more children - 15% off total. Please email: championsfootballacademyfc@gmail.com to inquire about family discount or payment plan option.

* Indicates required field

Name *

First

Last

Birthdate *

Gender *

Address *

School *

How did you hear about us? If a current member referred you, please list their name. *

Please indicate if you are registering for a clinic, camp, or the soccer season? *

Health Conditions *

Uniform shirt size? shorts size? *

Would a parent like to be a volunteer coach? *

Parent/Guardian Name *

Parent email & phone number *

** I HEREBY AUTHORIZE MY CHILD TO PARTICIPATE IN THE CHAMPIONS FOOTBALL PROGRAM AND I ASSUME ALL RISK AND HAZARDS INCIDENT TO SUCH PARTICIPATION, INCLUDING TRANSPORTATION TO AND FROM SAID ACTIVITIES, WAIVE, RELEASE, ABSOLVE, INDEMNIFY AND AGREE TO HOLD HARMLESS CHAMPIONS FOOTBALL ACADEMY, ITS AFFILIATES, THE ORGANIZERS, SUPERVISORS, OFFICERS, DIRECTORS, PARTICIPANTS AND PERSONS OR PARENTS SUPERVISING OR TRANSPORTING PARTICIPANTS FROM SUCH ACTIVITIES FROM ANY CLAIMS ARISING OUT OF INJURY TO MY CHILD. THE UNDERSIGNED AGREES THAT THEIR LIKENESS, OR THE LIKENESS OF THEIR CHILD MAY BE PHOTOGRAPHED OR VIDEOTAPED AND THAT SUCH IMAGE MAY BE PUBLISHED IN AN OUTLET USED TO PROMOTE OR PUBLICIZE THE SPORTS PROGRAM. **

Signature & Date *

Submit