Clone of Lake Worth(Atlantis) Saturday Program-De10 Indoor Soccer Facility

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Indoor Soccer Facility Lake Worth (Atlantis) Raptors Soccer Academy -Tuesday & Saturday Program 8 Week Fall Season (October 3-Nov.24)

Program Details: - 8 week program for ages 2-14- Twice a week every Tuesday 6:00pm-7:00pm & Saturday 10:00am-11:00am - All skill levels | No tryouts, everybody plays! - Training sessions are organized in groups based on the age of the child. - Fun and safe atmosphere -. Soccer Program is offered all year - NSCAA Certified Coaches - Field Location is De10 Indoor Soccer Fields 6228 S Congress Ave #B, Atlantis, FL, 33462. All sales are final. No Product may be returned to Seller without Seller's prior written authorization.

$379.00

Uniform

Full Uniform Kit; Raptors official Jersey with Number , shorts and socks

$55.00 Quantity

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Raptors Soccer Academy

Participant Registration Form
If you have any questions, please contact Academy Director, Luis Campo, at 954-361-4632 or raptors.socceracademy@gmail.com
Participant/ Player Information
Player first name
Player last name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Male or female
Address Information
Street address
Street address line 2
City
State
Postal zip code
Parent's Information
Parent/Legal Guardian 1 Full Name
Email Address
Phone number
Parent/Legal Guardian 2 Full Name
Phone number
Email address
example@example.com
Participant/Player Information
List any Player health problem/prohibition we should be aware of:
If none, please list N/A
What is Player jersey size?
Practice jersey's are provided to first time participants only
Player Participation Risk Statement

I, the Parent or Legal Guardian of the above-named participant (the "Player"), agree that the Player will abide by the rules of Raptors Soccer Academy, LLC. I fully understand that participating in the sport of soccer presents a risk for serious injury and death, and in consideration for Raptors Soccer Academy, LLC, am accepting Player participation in the soccer program and its activities (the "Programs"). I hereby release, discharge, and/or otherwise indemnify Raptors Soccer Acedmy, LLC, its affiliated organizations and sponsors, their employees, including the owners of the fields and facilities used for the Programs against any claim by or on behalf of the Player as a result of the Player's participation in the Programs. The Player has received a physical examination by a licensed physician and has been found physically capable of the Programs. I hereby consent to have an athletic trainer and/or doctor of medicine and/or dentist provide the Player with medical assistance and/or treatment in the event of a medical emergency and agree to be responsible financially for the cost of treatment.
Parent/Guardian Signature

Photo Release Form
It is the intention of Raptor's Soccer Academy, LLC, to provide a quality program to all its participants. In order to promote the program, advertise its participants' accomplishments, and create press releases and news stories, Raptors Soccer Acemdey may choose to post information and pictures and/or videos on its website, printed materials, social media, and provide stories to local newspapers. Please indicate below if you will allow or will not allow Raptors Soccer Acedemy, LLC to use your child's picture.
Do you grant permission for Raptors Soccer Academy, LLC to use pictures or videos of your child in print or online materials designed for news, informational, promotional or educational purposes related to its soccer program, and without compensation?
Parent/Legal Guardian Full Name
Parent/Legal Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Parent/Legal Guardian Full Name
Parent/Legal Guardian Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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Participant/Player Information

Photo Release Form