SESSION 2 // 2015 - 2012
7:05 - 8:05 PM
Child's Info
*
First Name
Last Name
Child's DOB
*
-
Month
-
Day
Year
Date
Parent Info
*
First Name
Last Name
Parent Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent E-mail
*
example@example.com
Which School, Club, or College/University do you play for?
Waiver
I or my child agree to participate in one or more physical fitness programs/classes affiliated with Deer Park Soccer FC and partnered facilities. This may include personal or open training from employees, officers, managers, and members. Deer Park Soccer FC made me fully aware that the fitness programs/classes they offer, in which I or my child desire to participate are extremely strenuous and may push the limits of my physical abilities. I, the undersigned, recognize and understand that the programs/classes are without varying degrees of risks which may include but are not limited to the following: injury to the musculoskeletal and/or cardio respiratory systems which can result in serious injury or death due to negligence on the part of myself or my child(s) , my training partner, or other people around me, injury or death due to improper use or failure of equipment, or injury or death to a medical condition, whether known or unknown by me or my child. I am aware that any of these mentioned risks may result in serious injury or death to myself or child. I fully understand and willingly assume full responsibility for any and all risks that I'm exposing myself to as a result of my participation in Deer Park Soccer FC programs. I accept full responsibility for any injury or death that may result from any participation in any activity, class, or physical fitness program. I also give my consent to the Deer Park Soccer FC to promote, market, and publicize any video and/or pictures of me on social media.
I have read the waiver above and agree to participate.
*
Yes
Futsal Friday
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Friday Night Futsal **we no longer accept cash**
1 Session
$10.00
$
10.00
Total
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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