Winter 2024 / 2025 Clinics Registration | Transylvania Gym & Soccer

Registration Fee: $350.00 per each participant at each session

To enroll, a Parent/Guardian must complete this Registration Form and submit it online (by clicking "I AGREE"). A check for $350.00, payable to: Transylvania Gym & Soccer, must be mailed to the following address: Transylvania Gym & Soccer LLC, 11 Grace Court, Bethel, CT 06801

I am registering my child for the following program:

SATURDAY 11:45 AM - 12:45 PM, BOYS & GIRLS born in 2011, 2012 & 2013

Child's Date of Birth

Emergency Phone Number

Parent/Guardian Signature

By typing your name above as the parent/guardian, you agree with the terms outlined below. To enable the Town of Mt Kisco, Rippowam Cisqua School and Transylvania Gym & Soccer LLC to accept registration and permit participation in the Town of Mt Kisco, Rippowam Cisqua School and Transylvania Gym & Soccer LLC’ s activities by the above named player. I player’s parent / guardian, hereby give my consent to his /her participation and agree to release, indemnify, and hold harmless, the Town of Mt Kisco, Rippowam Cisqua School and Transylvania Gym & Soccer LLC, their officers, directors instructors/coaches, and representatives from any claim out for injury arising out of the Town of Mt Kisco, Rippowam Cisqua School and Transylvania Gym & Soccer LLC’ s activities. In case of emergency I hereby authorize treatment and care of player by any hospital, doctor, or emergency or ambulance association.