Real JFC Player ID Camp Registration Form 2006-07

REAL JFC

2007 and 2008 Girls President's Day Player ID Clinic Registration Form
Player Name

First NameLast Name
DOB

MonthDayYear
CHECK WHICH SESSIONS YOUR PLAYER IS ATTENDING
PAYMENT OPTIONS
Parent/Guardian 1 Name

First NameLast Name
Parent/Guardian 1 Email
Parent/Guardian 1 Cell

Area CodePhone Number
Current Club Info

Club NameAge Level (i.e. U9A)
MEDICAL RELEASE STATEMENT

I, the parent/guardian of the registrant, a minor or adult registrant of legal age, agree that I and the registrant will abide by the rules of the Real Jersey Football Club ("Real JFC") and its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for Real JFC accepting the registrant for its soccer programs and activities ("Programs"), I hereby release, discharge and/or otherwise indemnify Real JFC and its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs, and/or being transported to or from the game, tryout, scrimmage, event or group practice which transportation I hereby authorize.
CONSENT FOR MEDICAL TREATMENT (MINOR)

As the parent or legal guardian of the above named player, I hereby give my consent for emergency medical care provided by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well being of my dependent.
Initial below to acknowledge that you have read and agree to the Medical Release Statement and Consent for Medical Treatment.
Date of Acknowledgment

MonthDayYear
Should be Empty:

REAL JFC