RAGE U9-U13 COMP SPRING SOCCER (NorCal League)

WHEN ARE THE SESSIONS?
TBD – check with team manager for specific schedule

WHERE WILL THE SPRING PROGRAM BE HELD?
TBD - detailed schedule to follow upon registration.

HOW MUCH DOES THE PROGRAM COST?
Spring Program is $400 – This program is open ONLY to players currently on a Rage competitive team.

NOTE: If your daughter is not selected for a Rage competitive team for Fall 2013 you will receive a full refund of spring fees.

REGISTRATION FORM

All fields in red are required

Player Information

First Name:	A value is required. Last Name: A value is required.
Address:	A value is required.
City:	A value is required.	State: A value is required. Zip: A value is required.Invalid format.
Birth Date	A birthdate is required.Invalid format.(Format: 12/25/1992) ;
Current Team:	A value is required. Current Coach: A value is required.

Parent Information

First Name:	A value is required. Last Name: A value is required.
Email:	A value is required.Invalid format. Retype Email: A value is required.The values don't match.
Phone:	A value is required.Invalid format. (Format: 916-555-1212)	Cell Phone:
Address:
Mark here if address is the same as player's information
Street:
City:	State: Zip:

Emergency Information

Emergency Contact: Friend or relative not living at same location	We must have an emergency contact
Relationship to Player	Relationship to player is required.
Emergency Home Phone:	A phone is required.Invalid format.(Format: 916-555-1212)
Emergency Work Phone:	A phone is required.Invalid format.(Format: 916-555-1212)
Medical or Other Comments:

Parent/Guardian Waiver

DISCLAIMER, ASSUMPTION OF RISK AND WAIVER: I, the undersigned parent or legal guardian of the above player, a minor, acknowledge that participation in soccer involves risk of severe, permanent physical injury, and death. For myself, and on behalf of the above player, we willingly and voluntarily accept and assume all such risk. In consideration of permitting the voluntary participation of the above-named participant in this tryout program, for myself and on behalf of the above player, I hereby release, discharge and agree to hold harmless Pleasanton RAGE, its employees, volunteers, officials, sponsors, and other representatives from any and all claims, demands, costs, expenses, and compensation arising out of or in any way related to any injury or other damage that may result to said participant while participating in any Pleasanton RAGE sponsored event, including any physical or other injury caused by the negligence of any such person while performing his/her duties at any time.
I HAVE READ THE DISCLAIMER, ASSUMPTION OF RISK, AND WAIVER AND FULLY UNDERSTAND THE TERMS OF EACH. I UNDERSTAND THAT I AND THE ABOVE PLAYER HAVE GIVEN UP SUBSTANTIAL RIGHTS BY MY AGREEING TO THESE TERMS, AND AGREE TO THESE TERMS FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT FOR MYSELF AND ON BEHALF OF THE ABOVE

Agree
You must agree to these terms to submit this form.

NOTE: If the form doesn't go to the "Thank You" page after you SUBMIT, please scroll up and review your input -- any errors on the form will show up in red - please correct any errors, and then re-submit!

Last Updated: February 13, 2013