register — SHS Eagles Soccer

CAMP REGISTRATION

Player Name

First Name

Last Name

Birthdate

YYYY

Player's Age (At time of camp)

Player's Shirt Size

Primary Phone

(###)

###

####

Secondary phone

(###)

###

####

Liability Release

I, the parent/legal guardian of the above player, a minor agree that the player and I will abide by the rules of the Eagles Soccer Team, Tennessee State Soccer Association and USYS, its affiliated organizations and sponsors. I recognize the possibility of physical injury associated with soccer and in consideration for Seymour Eagles Soccer Team, Tennessee State Soccer Association and USSSA accepting the above named registrant for its soccer programs and activities, I hereby agree to assume the risk of and hold harmless, release, discharge and/or otherwise indemnify the Eagles Soccer Team Tennessee State Soccer Association and USYSA, their affiliated organizations and sponsors, their employees and associated personnel, including the owners of the fields and facilities utilized for the programs, against any claim by or on behalf of the registrant, as a result of their participation in the programs and/or being transported to or from the same.

Photo Release

I hereby give permission to the Eagles & Lady Eagles Soccer Booster Club and Seymour First Baptist Church permission to use any photographs taken of my child while participating in this program for use as promotional media.

Guardian's Name

First Name

Last Name