ZORAN'S SOCCER CAMP
5699 Kanan Rd., #331
Agoura Hills, CA 91301

 

WINTER 2011 - ZORAN'S SOCCER CAMP REGISTRATION FORM

Place:  Calabasas, CA 91302

9:00-3:00  Full Day - $250.00            9:00-12:00  Half Day - $190.00

- Please circle desired week(s) and full or half day -

Week 1: December 19, 2011-December 23, 2011

Week 2: December 26, 2011-December 30, 2011

 

Player's Name_____________________________________________ Date of Birth_______________

Address_____________________________________________________________________________________

SKILL LEVEL _________Beginner _________Intermediate _________Advanced

School Attending_______________________________________________________________________

Phone:   Home _(       )______________________ Work _(       ) _____________________

E-mail_______________________________________________

Parent or Guardian_____________________________________________________________________


The undersigned agrees to defend, indemnify, and hold harmless the Zoran's Soccer and it's officers, employees and agents from and against any and all loss, liability charges and expenses (including attorney's fees) and costs whatsoever character which may arise by reason of participation in any program. (The Zoran's Soccer does not provide accident, medical, liability, workers compensation insurance for program participants). As parent/guardian, I hereby consent to emergency treatment of my minor child as a result of accident or injury. I further agree to pay any and all costs incurred as a result of said treatment. I agree to reasonably inspect and satisfy for myself that the facilities provided are safe for their intended use. Once having conducted the inspection, I agree to expressly assume the risk of participating at the premises. I understand the Camp retains the rights to use photographs or videos of campers taken at camp, for publicity and advertising purposes.

PARENT/GUARDIAN SIGNATURE

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