Narragansett Youth Sports

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World Cup Indoor Rec Soccer

PLAYER INFORMATION

* First Name:

* Last Name:

* Childs tee shirt size (dri fit):

Street:

City:

State:

Zip Code:

* Home Phone:

* Birthdate:

* Email:

* Gender:

* Please share your childs experience playing soccer: # of years, level played, ability, concerns, etc.:

* name of child's school currently attending:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

WAIVER AND RELEASE
I hereby agree to permit my child to participate in World Cup Indoor Soccer League.
I acknowledge that I have am aware of medical risks that may result in such participation and I represent that I have consulted my child’s physician and my child is physically capable of such participation without injury. I hereby waive and release Narragansett Youth Sports and The Narragansett School System from any claims, liabilities, and expenses arising from my participation in the above the program.

I/we agree with the above *

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World Cup Indoor Rec Soccer