Atheletes First Name	* required
Athletes Last Name	* required
Position	Field Player Goalkeeper
St. Address	* required
City	* required
State	NJ NY PA CT MD
Zip Code	* required
Gender	Male Female
Age	* required
Waiver	I myself, my spouse, my child, and on behalf of my/ our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, Net Edge Training,LLC, coaches, owners and instructors , other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the training (" Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, or loss or damage to person or property incident to my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I understand and accept that pictures/ videos taken at clinics, training and camps may be used for promotional purposes. I grant permission for my child to receive emergency medical treatment. I also assume full financial responsibility for any medical treatment for my child. BY typing YES BELOW I ACKNOWLEDGE THAT I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, THAT I FULLY UNDERSTAND AND AGREE TO ITS TERMS. Type YES in the box below to agree to waiver  * required
Parent or Guardian	* required
Home Phone	* required
Cell Phone	* required
E Mail	* required
Program Selection	MVP Striker/Keeper 6/28-7/1, Mt. Laurel NJ Champion Striker/Keeper 6/28-7/1 Mt. Laurel NJ Please confirm the program you selected is showing in the space above. If needed click the drop down menu to change.