UBC Soccer Academy

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Child's Information* This field is required.Please complete the following information.

First Name

Last Name

Preferred Name

Age of Child

Date of Birth (Month/Day/Year)

T-Shirt Size (all children sizes)

Register another child?

2

Second Child's InformationIf registering a second child, please complete the following information.

First Name

Last Name

Preferred Name

Age of Child

Date of Birth (Month/Day/Year)

T-Shirt Size (all children sizes)

Register another child?

3

Third Child's InformationIf registering a third child, please complete the following information.

First Name

Last Name

Preferred Name

Age of Child

Date of Birth (Month/Day/Year)

T-Shirt Size (all children sizes)

Register another child?

4

Please use the following space to ask any questions or share any special information (allergies, special needs, etc):

5

Parent's Information* This field is required.

First Name

Last Name

Email Address

Phone Number

6

If able, which of the following volunteer roles can you help:* This field is required.

Set-Up (8-8:45 am)

Player Check-In (8:45-9:10 am)

Group Guide (8:50-10:00 am)

Coaching (8:50-10:00 am)

Snack Distribution (9:50-10:10 am)

None At This Time

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Release Waiver and Agreement* This field is required.By checking this box, I agree to the following: I hereby give permission for my child to participate in the UBC Soccer Academy. I understand that participants will be engaging in activities, stretches, games, and other physical activities. I agree to be present and/or to have another guardian present with my child. In consideration of the entry being accepted, I hereby, for myself, heirs, executors and administrators to the extent permitted by law, agree to protect, indemnify, defend and hold harmless University Baptist Church, the Property Owners, Associated Groups any respective officers, employees, agencies, insurers, volunteers, other official sponsors from any liability against all claims, losses, damages, persons injury or worse, property and costs (including reasonable attorney’s fees) arising out of or connected with or participation in events associated with the UBC Soccer Academy, including, but not limited to: the set-up, removal, maintenance, occupancy or use of the property, owned or rented by listed parties above, or as a result of traveling to or from the event, except those claims arising out of the sole negligence or willful misconduct of listed parties. I further state that the participant is in proper physical condition to participate in the camp.

Agree

10

Photo Release * This field is required.By checking this box, I give permission for my child/children's photos to be used in online and printed materials related to Soccer Academy and/or University Baptist Church. Names will never be used in conjunction with pictures.

I AgreeI Disagree

11

Registration Payment* This field is required.Early Bird Registration Ends January 31st at 12:00AM CST. Regular Registration pricing $60/$50 is March 8th - April 12.

My Bag

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Single Player
$60.00Edit
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Subtotal: $0.00
Additional Player(s)
$50.00Edit
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Credit Card

First Name

Last Name