Camp Registration - Brazilian Way Soccer Training & Camps

Child's Name*

To be registered

Age*

D.O.B.*

XX/XX/XXXX

Gender*

School Name*

Grade*

Parent's Names:*

Address*

Address Line 2

City*

State*

Postal Code

Home Phone*

Work Phone

Emergency Contact Name*

First & Last Name

Emergency Contact Phone*

Email*

Adult T-Shirt Size

Youth T-Shirt Size

Total

I, the parent or guardian of the participant enter on this form, hereby authorizes Brazilian Way Soccer's coaching staff to act for me according to their best judgment in any emergency requiring medical attention, and hereby waive and release them, as well as owners and/or operators of property and/or facility, from any and all liability for any injuries, illness or loss of property incurred while attending the camp. Parents must inform the camp director of any special health needs.

You, the parent or guardian, by submitting this electronic registration/permission form agrees to the terms and conditions listed above and will be contacted in the event of an emergency.

Please enter the following code