St. Sebastian Soccer Clinic Sign-Up Form
Please provide your child's details and contact information to register for the sessions.
Child's Full Name
*
First Name
Last Name
Child's Age
*
Select Session (choose based on your child's age)
*
Ages 4-6
Ages 7-9
Ages 10-12
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Child (Emergency Contact)
*
T-shirt Size
Please Select
Youth XS
Youth S
Youth M
Youth L
Youth XL
My son/daughter is in good health and has my full permission to participate in the St. Brigid/Our Lady of Hope Summer Camp Program. He/she has no previous illness or bodily injury that is contradictory to participation. In the event I cannot be reached, I hereby authorize emergency or other medical treatment for my child that may be deemed necessary. I, individually an as the parent or guardian of the above named minor, ask that he/she be admitted to participate in the St. Brigid/Our Lady of Hope Summer Camp Program. In consideration of such admission, I do hereby release, discharge, and hold harmless St. Brigid/Our Lady of Hope Summer Camp, its officers, agents, coaches, of and from all causes, liabilities, damages, claims, or demands whatsoever on account of injury or accident involving said minor arising out of the minor's attendance at the St. Brigid/Our Lady of Hope Summer Camp program or in the course of competition and/or activities in connection with the program.
Parent/Guardian Signature
*
Sign Up
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