Participant Registration and Disclosure

Parent/Guardian Information

Emergency Information

  • In case of emergency where parent/guardian cannot be reached
  • In case of emergency where parent/guardian cannot be reached

Players Information (Single: $150, Multiple: $140 ea.)


  • Optional Extras



    (XS, S, M, L, XL)
    (XS, S, M, L, XL)

Disclosure

I, the parent/guardian of the registrant, a minor, agree that I and the registrant recognize the possibility of physical injury associated with soccer and in consideration of PLANET BALL SOCCER ACADEMY accepting the registrant for its soccer program and activities, I hereby release, discharge, and indemnify PLANET BALL SOCCER ACADEMY, its employees and associated personnel, including owners of fields and facilities utilized for said activities, against any claim by or on behalf of the registrant as a result of the registrant's participation in the activities, and/or being transported to or from the same, which transportation I hereby authorize.

Consent for medical treatment (minor)

As the parent or legal guardian of the above-named registrant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are deemed necessary to preserve the life, limb or well-being of the registrant.

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