Futsal Registration Form

BEAST Futsal ID Registration

Schedule a session
You will need to fill out one registration per child.
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Male/Female*
Current Outdoor Soccer Club
My preferred night to practice is:
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
By submitting the form, I, as the parent/guardian of the registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may given under whatever conditions are necessary to preserve the life, limb, or well-being of registrant.

By submitting the form, I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of BEAST Futsal, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with futsal and in consiideration for BEAST Futsal, accepting the registrant for its futsal programs and activities (the "Programs"). I hereby release, discharge and/or otherwise indemnifyt Ballers Elite, Ballers Elite East d/b/a BEAST Futsal, its affiliated organizations and sponsors, their employees and associated personnel, includin g the owners of fields and facilities utilized for the Programs, against any claimby or on behalf of th registrant as a result of the registrant's participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.
Should be Empty:

BEAST Futsal ID Registration

CHILD INFORMATION:

PARENT/GUARDIAN INFORMATION: