Clinics Registration

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Parent / Gaurdian Name
First Name
Last Name
2
E-mail
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Phone Number
Area Code
Phone Number
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Participant 1
First Name
Last Name
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Age
6
Gender
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Female
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Health Issues/ConcernsPlease be specific
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Program GoalsPlease be specific
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Participant 2
First Name
Last Name
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Age
11
Gender
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Female
12
Health Issues/ConcernsPlease be specific
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Program GoalsPlease be specific
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Camp Waiver & Release Agreement* This field is required.The risk of injury to my child from the activities involved with Loberg Athletic LLC, staff members, and facilities is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my child’s participation; and, I willingly agree to comply with Loberg Athletic LLC stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; Loberg Athletics LLC, directors, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, partnering facilities, and if applicable, owners and lessors of premises used to conduct the event releases, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law. I, for myself, my spouse, and my child HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releases from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law. I, the parent/guardian, assert that I have explained to my child: the risks of the activity, his/her responsibilities for adhering to the rules and regulations, and that my child/ward understands this agreement. I, MY SPOUSE, AND CHILD/WARD, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTANDING ITS TERMS, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY CHECKING THIS BOX
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Summer Programming* This field is required.
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World Cup Camp - 1 Participant Total
June 22-25th from 5:30-7:30pm. This camp is designed to celebrate the World Cup. This year's camp is in a World Cup Year so join us for a special year of World Cup fun. Ages are 6 - 12. Kids will learn about countries, sharpen skills, and play in a tournament.
$120.00Edit
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World Cup Camp - 2 Participants Total
June 22-25th from 5:30-7:30pm. This camp is designed to celebrate the World Cup. This year's camp is in a World Cup Year so join us for a special year of World Cup fun. Ages are 6 - 12. Kids will learn about countries, sharpen skills, and play in a tournament.
$200.00Edit
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3v3 Clinic - Partipant Fee
July 6th-9th 5:30-730pm
$90.00Edit
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3v3 Clinic - Multi Participant Fee
June 22-25th from 5:30-7:30pm
$160.00Edit
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