F4C Summer Training Registration

Registration Form Summer 365 Training - Cadets

8 to 11 Years - Mon, Tue & Thu, 5:30pm - 6:30pm
Select your preferred Location*

Ashburn VillageAldie / South Riding
Select your Program*

Pick my own dates - $70 per session 4 minimumMonthly $499 per month3-Month Summer Package (June to August) $1200
The regular price for our Full Summer (3 months) is $1135, look for the coupon in our main page to SAVE BIG!!
Select your Months*

June - $499July - $499August - $499
Select my Own Dates*

Monday June 2Tuesday June 3Thursday June 5Monday June 9Tuesday June 10Thursday June 12Monday June 16Tuesday June 17Thursday June 19Monday June 23Tuesday June 24Thursday June 26Monday June 30Tuesday July 1Thursday July 3Monday July 7Tuesday July 8Thursday July 10Monday July 14Tuesday July 15Thursday July 17Monday July 21Tuesday July 22Thursday July 24Monday July 28Tuesday July 29Thursday July 31Monday August 4Tuesday August 5Thursday August 7Monday August 11Tuesday August 12Thursday August 14Monday August 18Tuesday August 19Thursday August 21Monday August 25Tuesday August 26Thursday August 28
Player Information
Athlete's Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Age*
Grade
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name*

First NameLast Name
Home Number
Cell Phone*
Please enter a valid phone number.
Work Number
Relationship to the Player*
E-mail*
example@example.com
Emergency Information
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 give my approval for my child’s participation in any and all activities prepared by F4C Soccer during the selected training. In exchange for the acceptance of said child’s candidacy by F4C Soccer. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless F4C Soccer and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected training sessions.

In case of injury to said child, I hereby waive all claims against F4C Soccer including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. In the event of any medical emergency, I authorize and consent for a representative, officer or partner “F4C Soccer” to act on my behalf for medical care deemed necessary for the participant.
Photo /Media Release

I hereby give permission for my child to be photographed and video recorded during the F4C Soccer Programs, By Coach Carlos Vera, Assistants, Club officers and hired marketing professionals. I understand the photos/media material will be used to keep a journal of activities, to share during power point presentations and/or reports and for promotional purposes including flyers, brochures, newspaper and on the internet, social media platforms. I understand that although my child’s media material may be used for advertising, his or her identity will not be disclosed or sold, I do not expect compensation and that all photos/ media material are the property of F4C Soccer and its affiliates.
Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the F4C Soccer . and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Refund Policy

F4C Soccer and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per physician orders

F4C Soccer has a zero tolerance for bullying and bad behavior of any kind or level, we have a three-strike rule and parents will be informed of each occurrence. At the third event of such behavior, child will be released from the program immediately banned for 12 months. No refunds will be issued.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date*

MonthDayYear
Date
Signature*

Clear
Payment Information
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Coupon Code
Total Amount Months
Total Amount due Today
Total Amount Sessions
Total Amount Full Summer
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Congratulations!! you got a 15% Friends and Family Discount
Congratulations!! you got a 10% Discount
Your total Amount before discount is ${totalAmount}, the amount to pay after discount is ${totalAfter}
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Registration Form Summer 365 Training - Cadets

Player Information

Payment Information

Invalid Coupon Code

Congratulations!! you got a 15% Friends and Family Discount

Congratulations!! you got a 10% Discount