GLGK Medina Summer Camp U9 - U19
June 15th - June 18th 6:00PM-8:00PM 313 Medina Rd, Medina, OH 44256
Player Name
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First Name
Last Name
Player Age
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Address
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Street Address
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Email
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example@example.com
Club Team
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Summer Camp
$
190.00
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Release I verify that my child has been checked recently by a physician and is physically able to participate in soccer activities. Also, as a parent/guardian, I authorize any first aid or emergency care that may become necessary for my child while he/she is participating. Further, I understand that there is an inherent risk of injury in playing soccer. Consequently, I hereby release and hold harmless, Great Lakes Goalkeeping Academy, Jason Kubbins, or his staff and from liability should any injury, loss of life, or loss/damage to equipment that may occur during the camp. By executing this document, I hereby assume all risk of injury or lost or damaged property. In case of emergency, this form and signature will serve as authorization for a hospital to administer medical treatment. All pictures, videos, and contact information collected by Great Lakes Goalkeeping Academy may be used at the discretion of Jason Kubbins for promotional use.
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