On The Ball Soccer Medical Release And Registration Form
ADVERTISEMENT
1
2On The Ball Soccer
MEDICAL RELEASE AND REGISTRATION FORM:
(MUST BE FILLED OUT BY EVERY PLAYER)
“I, the undersigned parent/legal guardian of ____________________________________ (player’s name) authorize
said child’s full participation in the On the Ball Soccer and all related training activities. I hereby release, waive,
discharge and covenant not to hold responsible On The Ball Soccer, LLC., its staff, or any staff from any and all
liability, claims, demands, action related to any loss, damage, or injury that may be sustained by my child, whether
caused by the negligence of the releases, or otherwise participating in such activity, or while in the premises where the
activity is being conducted. I also give permission for any emergency medical treatment or care by a physician,
surgeon, hospital, or medical care staff that may be required, including transportation, and accept responsibility for the
cost.”
Player’s name__________________________________________________________________________
age_________
gender__________
birth date__________________
year___________
Parent (s) name: ________________________________________________________________________
Parent/legal guardian signature____________________________________________________________
Address______________________________________________________City_______________________
State ______ Zip Code__________ Email __________________________________________________
Emergency phone numbers____________________________
Cell____________________________
Coach: ___________________________
Team: _____________________
Age Level (U?): _____
MAIL YOUR CHECK AND REGISTRATION FORMS TO:
On The Ball Soccer, LLC
3001 S. Hardin Ste. 110 #126
McKinney, TX 75070
Please make checks payable to: ‘On The Ball Soccer’
Team Training (OTB Use Only)
Date(s):
Trainer:
Level 1
(TBD)
Date(s):
Trainer:
Level 2
2-4 players - $25 pp/ph
5-9 players - $15 pp/ph
10+ players - $10 pp/ph
Date(s):
Trainer:
Level 3
2 players - $25 pp/ph
3-4 players - $20 pp/ph
5-9 players - $15 pp/ph
10+ players - $10 pp/ph
Date(s):
Trainer:
Level 4
2 players - $20 pp/ph
3 players - $18 pp/ph
4 players - $15 pp/ph
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal