Bia Force Academy High School Prep Camp Registration

The high school prep camp will take place:

Dates: Fridays - April 26, May 3, May 10, May 17

Time: 4:00pm-5:30pm

Location: Mountview Park (1651 E Fort Union Blvd)

*All players are required to arrive properly dressed for soccer training (shorts, socks, cleats, shin-guards).

*All athletes and parent/guardian must fill out the athletic waiver and and release form included below. Any athlete without a waiver on file will not be allowed to participate.

Cost: $130 for 4 sessions (includes training shirt)

Payment can be made via credit card upon completion of this registration or with cash at check-in. If paying with cash use coupon code "cash" at check-out.

Athlete Information

Athlete's Name*

First NameLast Name

Birth Date*

MonthDayYear

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

What high school will you be attending?

What grade are you currently in?

What position(s) do you currently play?

T-shirt size (womens)*

Parent/Guardian Information

Name*

First NameLast Name

Cell Number *

Area CodePhone Number

E-mail *

Confirmation Email

Address (if different from the athlete listed above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Emergency Contact Information

Name*

First NameLast Name

Relationship

Phone Number*

Area CodePhone Number

Alt-Phone Number

Area CodePhone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please provide any instructions.

AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY

READ BEFORE SIGNING

In consideration of being allowed to participate in any way in Bia Force Academy athletic sports program(s), related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) from the activities involved in this program are significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Bia Force Academy their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Participant Name*

First NameLast Name

Participant Signature*

Date Signed

Date

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of the activity and his/her responsibilities for adhering to the rules and regulations. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s/ward’s involvement or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

Parent/Guardian Signature*

Parent/Guardian Name*

First NameLast Name

Date Signed*

Date

Confirmation

BY AGREEING ABOVE AND SUBMITTING THIS FORM, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT IS EQUIVALENT TO AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Please verify that you are human*

My Products

Girls High School Soccer Prep Camp$130.00

Designed to give athletes a head start on their high school soccer tryout preparation.

Enter coupon

Total $0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

High School Soccer Tryout Prep Camp