Register here for Christ Lutheran Soccer Camp 2018.
Please register each child separately.
Child's Name*
Child's Age*
5
6
7
8
9
10
11
12
Parents' Names*
Address*
City*
State*
Zip*
Phone Number*
Email Address*
Emergency Contact*
Emergency Phone Number*
Anything we should know about the health of any participating children with relevance to the activities we have planned (i.e. asthma, insect stings, food allergies, etc.)
Parental Consent and Participation Waiver
THE PARTICIPANT IS RESPONSIBLE FOR HIS OR HER OWN MEDICAL COVERAGE NOTICE OF WARNING: There is a potential risk in training and participating in any sport, and we have tried to create a safe environment. The coaches have established rules for participation, and proper conduct on or about the playing field must be followed. AGREEMENT: I have read and understand the policies and the risk involved. By checking the "Yes" box below, I hereby agree that my children will follow all rules for good order and safety during this camp. By checking the "Yes" box below I also agree and understand that neither Christ Lutheran Soccer Camp nor any of the churches sponsoring said camp, nor any of the volunteers involved are liable for any injuries received while participating or playing in the activity for which I am registering herein, or for the loss or damage to equipment. I agree that I shall make no claim and bring no action, suit, or proceeding for any and all damages, losses, liabilities, or costs in any manner suffered or incurred as a result of my participating in the activity for which I am registering herein, and I hereby release Christ Lutheran Soccer Camp and its officers, directors, and pastors from any and all damages, liabilities, or costs in this regard.*
Yes
Photo Release
We will be taking pictures during Christ Lutheran Soccer Camp. By checking the box below, you grant permission for Christ Lutheran Church to use the photo of your child as follows: In informational and promotional purposes of Christ Lutheran Church, such as websites, pamphlets, PowerPoint presentations and other promotional materials and displays. I understand that I may revoke my permission at any time by sending a letter to the director of Christ Lutheran Soccer Camp. Rescission of permission will take effect upon receipt of revocation.*
Yes
Christ Lutheran Soccer Camp is a ministry of Christ Lutheran Church. Please check all that apply:
We are members at Christ Lutheran Church
We are members at a different church.
We are not attending church at the present time.
We would like more information about Christ Lutheran Church and Samuel Lutheran School and its children's programs.
Your Name
Please type the full name of the person filling out this registration form.*
