Winter Camp Registration

Winter Camp Registration Form

January 7, 9, 14, 16, 21, 23, 28, & 30

Cost $120.00

Complete the registration form below, make your payment and bring your receipt on the first day of camp.

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PLAYER'S INFORMATION:

* for Safari please input date in this format YYYY-MM-DD

PARENT/GUARDIAN INFORMATION:

KSA WAIVER:

Recognizing the possibility of physical injury associated with soccer and in consideration for the Kalonji Soccer Academy accepting the registrant for its soccer activities, I hereby release, discharge and/or indemnify and agree to hold harmless the Georgia State Soccer Association, Kalonji Soccer Academy the organizers, supervisors, officers, directors, participants and persons or parents supervising or transporting participants to or from such activities from any claims arising out of injury to my child.

My son/daughter has been found physically capable of participating in the programs. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment.

By registering to this event, I hereby give approval for the participation of my child in any and all State Soccer Association / Kalonji Soccer Academy activities and I assume all risk and hazards incident to such participation, including transportation to and from said activities. I waive, release, absolve, indemnify, and agree to hold harmless the Georgia State Soccer Association, Kalonji Soccer Academy the organizers, supervisors, officers, directors, participants, and persons or parents supervising or transporting participants to or from such activities from any claims arising out of injury to my child.