Soccer Class Registration If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Parent Information First Name Last Name Email * Phone * Player/Participant Information Player/Participant First Name * Player/Participant Last Name * Address 1 * City * State * Arizona Delaware District of Columbia Maryland Zip / Post Code * Birth date * Alternate Phone Emergency Contact Name * Emergency Contact Phone * Additional Information about the player Permission to Participate * By checking the "permission to participate box", I hereby affirm that I am the parent/legal guardian to the child/participant, and I give the child/participant my permission to participate in SureSports soccer and recreational activities. I also agree and understand that all deposits, payments and registration fees are non refundable under all circumstances. Waiver of Liability and Assumption of Risk * By checking "Waiver of Liability and Assumption of Risk box", I release Sure Sports, LLC and its workers and contractors from all liability relating to injuries that may occur during Sure Sports, LLC recreational, soccer and training activities. By checking the box above I agree to hold Sure Sports, LLC free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. Additionally I affirm that my child/participant is in good health and in proper physical condition to participate in Sure Sports, LLC soccer/recreational activities. I also understand and acknowledge the risks involved in my child’s/participant’s participation in Sure Sports soccer recreational activities and training. These risks includes but are not limited to the potential for serious bodily injury, permanent disability, paralysis and loss of life; loss of or damage to equipment failure; injuries resulting from situations beyond immediate control of Sure Sports, LLC; and other undefined, not readily foreseeable and presently unknown risks and dangers. I understand that these risks may be caused in whole or in part by my child’s/Participant’s own actions or inactions, the actions or inactions of other participants in the classes, or other acts and I hereby release Sure Sports, LLC and its contractors from all liability.