Advanced Training Clinic Registration Page

Summer Select Clinic

Player Name *

Email Address *

Phone *

Age *

Clinic *

Years of Experience

Medical Emergency *

I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill.

Medical Expenses *

I understand that the SelectFutWork and/or its Staff will not be responsible for the medical expenses incurred, but that such expenses will be my responsibility as parent/guardian.

Photo Release *

I understand the photos will be used to keep a journal of activities, to share during power point presentations, for promotional purposes including flyers, brochures, newspapers and/or reports to our donor SelectFutWork.

Terms *

The SelectFutWork and its co-organizers are not responsible for lost or damaged personal property.
All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per physician orders. The child’s photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).

Payment Terms *

All payments MUST be received prior to the players starting. Players not paid will not be able to play or train until payments have been made.

Coupon Code

CheckboxApply 30% Discount

Signature *By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Grand Total