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Camp Phoenix AZ USA, December 2010 / Sign Up

Phoenix football Camp 2010 Registration Form

 

Please fill out the online form

...or print a copy of Registration Form and return to:

"Football Camps Phoenix LLC"
4240 E.Elwood Street
Phoenix, Arizona 85040,
USA

IMPORTANT NOTICE & WAIVER

Deposit amount of $100 is nonrefundable and will keep your spot on the camp, but does not guaranty the discounted price.
In order to get discounted price of $220, full amount must be paid before November 1st. 

Registration will not be processed without full payment. Receipt of such payment certifies that the applicant (applicant’s parent/guardian) has read and understands the Football Camp Phoenix policies in regard to medical attention, liability, medical expenses, personal items, refunds and cancellations and that a parent/guardian signature will accompany the Football Camp Phoenix registration form attesting thereto.

Agreement

I, the parent /guardian of the below-named player, a minor, agree that I and the player will abide by the rules and regulation of the Football Camp Phoenix, Arizona. In consideration of the players participation in the soccer programs and activities of the FC Phoenix Parties, I, for myself and player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the FC Phoenix parties, the owners and operators of the facilities used for the Programs, and their respective directors, coaches, trainers, employees, agents, and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the players participation in the Programs including, without limitation, players transportation to/from and Program, which transportation is hereby authorized. I further grant the FC Phoenix Parties right to use the players name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the players status as a participant in the Programs.
Also, hereby I confirm all provided info to be correct.

Consent of Medical Treatment

As the parent of legal guardian of the above named player, I hereby give consent for emergency. Medical care prescribed by a duly licensed Doctor of Medicine or Doctor of dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependant.


2010 December another day in the camp

Sign Up


Player Info

Name of Player
Age DOB
Team Player Email
Parents Email
Street Address
City Zip
State  
 
Home phone Work phone
Cell phone  
 
Total amount $270
 

Please read carefully the Important Notice& Waiver displayed on this page before signing this application.

Hereby, I CONFIRM of reading and understanding in full, Important Notice and Waiver announced by FC Phoenix LLC.

Parent/Guardian Info

I am: Mother
Father
Legal guardian
Name Phone
City Zip
List any medical problems or prohibition of player

please type in "x" or "none" if no info needed
Person to notify in emergency Phone
Doctor to notify in emergency Phone
Health Insurance Company name Group/Policy number
 

Please read carefully the Important Notice& Waiver displayed on this page before signing this application.
Hereby, I GIVE CONSENT for emergency.

 

* every field is obligatory

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