Gwinn Soccer Camp Registration Form June 22, 12 noon to 2 PM. .

Gwinn Soccer Camp Registration Form NEW - KI Sawyer Soccer Camp, July 13, noon to 2pm! Will take place by the Disc Go

Location: Old school behind Peter Nordeen Park. Opposite Car Show! A second camp will be held in July at KI Sawyer. You will be notified.
Athlete Information
My youth athlete will attend the Fun Daze Soccer Camp (Yes or No) blanks. My youth athlete will attend the KI Sawyer Camp (Yes or No)blank .
Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Ages 5-10 only for this camp
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information
Name

First NameLast Name
Home Number
Cell Number
E-mail
example@example.com
I am interested in helping start a Gwinn Soccer Club

Click here
Emergency Information - Please have phone with you!
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone 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 explain any instructions.
Informed Consent and Acknowledgement

I hereby provide my consent for my child's participation in all activities organized by the Gwinn Lions soccer camp during the chosen camp session. By accepting my child's participation, I acknowledge and accept all the potential risks and hazards associated with these activities. I release, exempt, and indemnify the Gwinn Lions soccer camp and all its officials, representatives, and agents from any responsibility for injuries that may occur to my child during their travel to, engagement in, or return from the camp sessions.

If my child sustains an injury, I waive any claims against the soccer camp, including its coaches, affiliates, fellow participants, supporting organizations, advertisers, and, if applicable, the owners and landlords of the premises where the event is held. Engaging in sports activities, including soccer, inherently carries a risk of injury, which may include but is not limited to fractures, paralysis, or even fatality.
Medical Release and Authorization

As the legal guardian of the youth athlete listed and in the event of a medical emergency, the Gwinn Lions Soccer Camp staff treat as best as possible the youth athlete however, we do not provide qualified and licensed medical professionals to diagnose and administer treatment.

As the legal guardian, I also authorize the affiliated individuals, including Directors, Coaches, and Team Parents, to provide only basic treatment.

This consent is valid during the event. I willingly provide this authorization to ensure prompt medical treatment under emergency circumstances, safeguarding the life and well-being of the named minor child when I am not present.
Should be Empty:

Gwinn Soccer Camp Registration Form NEW - KI Sawyer Soccer Camp, July 13, noon to 2pm! Will take place by the Disc Go