FUTSAL SOCCER Forms
Lady Patriot Futsal Soccer League
Registration Form
What: Futsal Soccer League.
Who: Girls interested in playing soccer.
Where: First Colonial High School Gym.
When: Sundays starting December 10. Times TBD
LEAGUE FEE: $75.00 (make checks payable to: (LADY PATRIOTS SOCCER CLUB).
**Funds from Futsal will be used at the discretion of the club for the 2024 Patriot Soccer Season**
General Information:- Play will be 5v5 with small goals (no goalkeepers) or 4v4 with keepers.
- Teams will be assigned according to year in school and ability.
- Games length will be (TBD) depending on number of Teams. (no halftime).
Name___________________ Circle one: Fresh. Soph. Junior Senior
Parent/Guardian Name(s) ____________________________________
Address_________________________________ Home Phone ___________________
Emergency contact________________________ Contact Phone __________________
T-shirt size: S M L
Playing Level
1 2 3 4 5
Recreation Advanced Select
PLEASE SIGN THE RELEASE FORM ON THE BACK AND RETURN BEFORE November 28nd.
LADY PATRIOT FUTSAL
SOCCER LEAGUE
I,_________________________________ DO HEREBY FOR MYSELF, MY HEIRS, AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL CLAIMS TO DAMAGE AGAINST FIRST COLONIAL HIGH SCHOOL, THE PATRIOT SOCCER LEAGUE AND ITS AGENTS OR AUTHORIZED REPRESENTATIVES, AS A RESULT OF ANY AND ALL INJURIES INCURRED BY ME FROM OR WHILE PARTICIPATING IN THE ABOVE MENTIONED PROGRAM.
____________________________________ _______________________________
Signature of Parent Date
____________________________________ _______________________________
Signature of Player Date
SOCCER LEAGUE
I,_________________________________ DO HEREBY FOR MYSELF, MY HEIRS, AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL CLAIMS TO DAMAGE AGAINST FIRST COLONIAL HIGH SCHOOL, THE PATRIOT SOCCER LEAGUE AND ITS AGENTS OR AUTHORIZED REPRESENTATIVES, AS A RESULT OF ANY AND ALL INJURIES INCURRED BY ME FROM OR WHILE PARTICIPATING IN THE ABOVE MENTIONED PROGRAM.
____________________________________ _______________________________
Signature of Parent Date
____________________________________ _______________________________
Signature of Player Date