Davenport Wildcats Youth Sports Program
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2015 SUMMER Soccer Saturday Clinics
CLINIC FEE ONLY $20
Summer Striker Wildcat Clinic Form
File Size:
515 kb
File Type:
pdf
Download File
Summer Soccer clinic
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Indicates required field
Athlete's Name
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First
Last
Boy/Girl
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Boy
Girl
School
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Current Age
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2015/2016 Grade
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2nd
3rd
4th
5th
6th
7th
8th
Next Falls grade level
Birthdate
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MM/DD/YY
Parent Address
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Address, City, State, Zip
Cell Phone Number
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Ok to text this number?
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Yes
No
Info on change of venue or cancellation due to weather or other updates
Email
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Payment Options
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Will mail in payment and wavier 1326 Meadowview Lane, Davenport, IA 52806
Will bring payment and wavier to first session June 6
Camp T-Shirt Size
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Youth Small
Youth Med
Youth Large
Youth XL
Adult Small
Adult Med
Adult Large
Adult XL
XXL
Additional T-Shirt Order $10
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None
YS
YM
YL
YXL
Small
Medium
Large
XL
XXL
Parent Acknowledgement
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Entering your Name is an Acknowledgement and Assumption of Risk: I am aware of the dangers and risks to my child and my child’s property while participating in Wildcats Soccer through the River’s Edge Strikers Soccer Club and all events related thereto. I understand that this activity involves certain risks for physical injury. I understand that the equipment which may be provided for my child’s protection may not prevent serious injury. I also understand that there are potential risks of which I or my child my not presently be aware. Nevertheless, I voluntarily elect to allow my child to participate in the Wildcats Soccer through River’s Edge Striker Soccer Club program with full knowledge of the danger and risk involved, and I hereby agree to accept and assume any and all danger and risk of property damage, personal injury, or death. Wildcats Soccer and/or River’s Edge Strikers Soccer Club do not insure participants in the above-described activity and participants who desire coverage must obtain their own insurance. Wildcats Soccer and/or River’s Edge Strikers Soccer Club asserts lack of responsibility or liability for injury resulting from this activity. Waiver of Liability and Indemnification: In consideration for allowing my child to participate in the above-referenced activity, I hereby: a. waive, release and discharge Wildcats Soccer, River’s Edge Strikers Soccer Club, their officers, employees, agents, representatives and affiliates from any and all negligence and liability for my child’s death, disability, personal injury, property damages, property theft or claims of any nature which may occur as a direct or indirect result of my child’s participation in the above-referenced activity; and b. defend, indemnify, and hold harmless Wildcats Soccer, River’s Edge Strikers Soccer Club, their officers, employees, agents, representatives and affiliates from any and all claims of any natures, including all costs, expenses and attorneys’ fees which may result from or arise out of this agreement. I hereby consent for my child to receive medical treatment which may be deemed advisable in the event of injury, accident or illness during the above-referenced activity. This release, indemnification and waiver shall be construed broadly to provide a release, indemnification and waiver to the maximum extent permissible under applicable law. I affirm that I am the parent or guardian of the child participating in the above-referenced activity and am freely executing this agreement. I have read this form and fully understanding that by signing the form I am giving up legal rights and/or remedies which may otherwise be available regarding any injury or loss my child may sustain as a result of his/her participation.
Comments/Questions
*
Submit
The Davenport Wildcats YSP are dedicated to build a tradition of excellence at Davenport North High starting at the Foundation, the Feeder Programs. SPORTS. PRIDE. FUN.