Pro Soccer Kicks
THE YARD camp

Date:	June 10-13 (Monday-Thursday)
Time:	8am - 10:30am
Ages:	Girls only: born 2011-2013
Location:	THE YARD: 805 N. Lake Minneola Dr. Minneola FL 34715
Cost:	$225 cash per player

This will be an exclusive camp, only for competetive players.

We will be sold out at 12 girls.

There is not parking at THE YARD. Please just drop off and pick up.

If you don't have a waiver on file with us Carrie will be out front at drop off to have you sign one.

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Player Information:

Player First Name: *

Player Last Name: *

Birth Year of Player: *

Players Address: *

City: *

State: *

Zip Code: *

Email address: *

Phone # you can be reached at during the camp: *

Waiver

There are risks connected with my child's participation in this activity. I release, waive, discharge and covenant not to sue Pro Soccer Kicks, event sponsors, THE YARD, City of Minneola, Lake County or employees and directors of Pro Soccer Kicks from all action, suits and demands whatsoever in law or in equity from demand, losses or damages on account of sickness or injury including death caused in whole or in part by the negligence of the releasee or otherwise. I hereby acknowledge the contagious nature of Covid-19 and voluntarily assume the risk that the named participant, my family, or myself may be exposed to and/or infected by Covid-19 by participating in ProSoccerKicks camps/clinics and that such exposure or infection may result in personal injury, illness, permanent disability and/or death. In case of an emergency and if I cannot be reached, I the undersigned parent or guardian of the above named child, do hereby consent to any x-ray, anesthetic, medical, or surgical diagnosis or treatment and hospital care deemed advisable and rendered by any licensed physician or surgeon. This authorization is given in advance of any required care to empower a representative or other official of Pro Soccer Kicks to give consent for such treatment as the physician may deem advisable. The authorization is effective unless revoked in writing. I accept full responsibility for any medical expenses incurred as a result of these actions. Child may not participate in camp unless parent/guardian agrees to the waiver: *

Agree

Do NOT Agree

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