Naples Soccer Academy Registration

Naples Soccer Academy Registration

Supplemental Soccer Training Held at North Collier Regional Park- Permitted Fields. Female Driven Ecosystem-- Naples Soccer Academy (NSA) is a club-neutral 501(c)3 non-profit, dedicated solely to advancing female youth soccer training and development in Southwest Florida. NSA provides elite-level soccer instruction led by collegiate and professional female athletes with a mission to empower youth female athletes both on and off the pitch. "Our goal is to create an organization where female athletes are given the resources, opportunities and leadership. "Youth soccer should be player-focused and accessible. We are building a culture that prioritizes the growth and development of female athletes at every level."
Athlete Information
Athlete's Name

First NameLast Name
Birth Date

MonthDayYear
Grade
Female
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
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Please tell us about your Athlete so that we can assist you better. What is her current level of play on scale 1-10 with 10 being the highest? What is preferred field position? What is the name of her current Club? As the parent, what do you feel she needs to improve upon? Please share further thoughts.
How did you hear about Naples Soccer Academy?
Informed Consent and Acknowledgement

I hereby provide my consent for my child's participation in all activities organized by the 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 Naples Soccer Academy and all its board members, 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 training.

If my child sustains an injury in the course of training, I waive any claims against Naples Soccer Academy, 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 serious 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, I hereby grant permission for qualified and licensed medical professionals to diagnose and administer treatment in the event of a medical emergency. This authorization is applicable when, in the medical professional's judgment, immediate attention is necessary to prevent further harm to the minor child's life, physical appearance, physical functionality, or to alleviate undue pain, suffering, or discomfort should there be a delay in treatment.

I hereby give consent to the attending physician to undertake any necessary medical or minor surgical procedures, conduct X-ray examinations, and administer immunizations to the youth athlete named. In cases of a serious illness, the requirement for major surgery, or significant accidental injury, I am aware that the attending physician will make every reasonable effort to contact me as swiftly as possible before proceeding with treatment. This authorization is granted after a reasonable attempt has been made to reach me.

I also authorize in the event of serious injury to my child that the affiliated individuals, including Directors, Coaches, and Team Parents, to provide essential emergency treatment before the child is admitted to a medical facility.

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.
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