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 MERLIN SOCCER CLUB TEAM & PRIVATE TRAINING TOURNAMENTS NEW! CAMPS
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MERLIN SOCCER CLUB

Application / Aplicaci�n

 

Family Information

 

Parent Name / Padres

Street Address / Direccion

Town / City / Ciudad

State / Estado

Zip / Codigo Postas

Home Phone / Telefono

Daytime Phone / Telefono

E-Mail / Correo Electronico (Important):

Family Doctor                         Doctor Phone

Player Information

 

Player Name / Nombre

Age / Edad

Gender / Sexo

Date of Birth / Fecha Nac

Current Team

Are you Goalkeeper:             Yes          No      

Positions Played

 

 PARENT / GUARDIAN CONSENT AND WAIVER

I hereby represent that the above information is true and accurate and the named applicant is in good health and has my permission to participate in the Merlin Soccer Club. I acknowledge that soccer is a contact sport and that there is a risk of injury from participating in the camp and its related activities. I HEREBY WAIVE AND RELEASE Merlin Soccer Club, Merlin Villagomez and its agents, servants and employees from any and liability and claims for damage. In the event of an emergency  I hereby give permission to such Medical personnel as necessary to render treatment.

-----------------------------------------                                  ------------------                                                                                                                                                                                                                      Parent/Guardian   Signature                                      Date

A deposit of $176 is required with each application.                                                                                                                                                                                                                       Please return application and checks payable to:

MerlinSoccerClub                                                                                                                                                                                                                                                       727 Jackson Ave,  #2                                                                                                                                                                                                                                              Elizabeth NJ 07201