SPORTS REGISTRATION FORM
Woodend Indoor Soccer
Parent/Guardian: _________________________________________________________
Home Address: __________________________________________________________
Home Phone:___________________ Mobile _______________________
Emergency Contact Name/ Phone:______________-__________________________________
Email :___________________________________________________________________
Doctors Contact____________________________________________________
Special Needs/Requests: ______________________________________________________________
I understand that the purpose of Indoor soccer is fun, personal growth and skill development. Woodend Indoor Soccer has my permission to use any photographs of my self/child for promotional purposes. Signature: _____________________________________Date:__________________
Please Note : Only white soled trainers are permitted in the Community Centre.
NAME | AGE | GENDER M/F | D O B | FEE $40 per child per term |
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WAIVER: The participant registered in Woodend Indoor Soccer understands that participation in any recreational activity subjects the participant to a certain degree of risk of injury and that the Woodend Indoor Soccer and staff will not be liable for medical expenses and other claims for damages based upon any injury to or for damage to any of the personal property of said registrant as a result of participation in these recreational activities. In the event I cannot be reached in an emergency, I authorize Woodend Indoor Soccer to secure proper treatment for my child.
Parent/Guardian
Signature_______________________________________Date:_____________________
Printed Name:_________________________________________
Print and return with fee : To C Brittain, 6 James Drive, Woodend
Right click mouse and press print