Player's name *

First Name

Last Name

Date of birth *

MM

DD

YYYY

Player's experience *

Beginner

Recreational

Competitive

Sibling (if any)

First Name

Last Name

Date of birth (sibling)

MM

DD

YYYY

Player's experience (sibling)

Beginner

Recreational

Competitive

Parent's name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please check the box after reading: *

By checking this box I hereby provide my consent for my child's participation in all activities organized by Soccer Roots, during the chosen program. By accepting my child's participation, I acknowledge and accept all the potential risks and hazards associated with these activities. I release, exempt, and indemnify Soccer Roots, LLC and all its officials, representatives, and agents from any responsibility for injuries that may occur to my child during their training and game sessions. If my child sustains an injury, I waive any claims against Soccer Roots, LLC including its coaches, affiliates, fellow participants, supporting organizations, advertisers, and, if applicable, the owners and landlords of the premises where the event is held. Engaging in sports activities, including soccer or futsal, inherently carries a risk of injury, which may include but is not limited to fractures, paralysis, or even fatality. I also hereby provide consent to Soccer Roots, LLC to use photographs or videos of my child(s) named above for marketing and social media purpose.

ACCEPT