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2010 Striker/Keeper Registration!

Atheletes First Name

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Athletes Last Name

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Position

St. Address

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City

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State

Zip Code

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Gender

Age

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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, DEATH or loss or damage to person or property incident to my own or 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 the participant to receive emergency medical treatment. I also assume full financial responsibility for any medical treatment for the participant 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

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Parent or Guardian

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Home Phone

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Cell Phone

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E Mail

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Program Selection

Please make sure the correct time and age group is shoing in the box above.
 

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