Legia Soccer Camp Registration Form

Player Information

Players Name*

First NameLast Name

Birth Date*

DayMonthYear

Gender*

MaleFemale

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Level of playing experience*

Player Height in cm*

Player Weight in kg*

Parent/Guardian Information

Name*

First NameLast Name

Mobile Number*

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Does the player have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the player prescribed an inhaler? If yes, please explain any instructions.

How did you find out about Legia Soccer Schools?*

Payment*

Legia Soccer Schools Camp Fee

$450.00AUD Quantity

Subtotal

$0.00AUD

Tax

$0.00AUD

Total

$0.00AUD

Credit Card

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 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, 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 also authorize the affiliated individuals, including Directors, Coaches, and Team Parents, to provide essential emergency treatment before the child is admitted to a medical facility.

This consent is valid during the dates and for the duration of the registered season. 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.

Legia Soccer Schools Camp Registration Form

Credit Card