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Transylvania Soccer
WILTON PLAYER REGISTRATION
Player’s Name ----------------------------------------------------Date
of birth-------------------------
Address-------------------------------------------------------------------------------------------------------
Town------------------------------------------------------------------State--------------------Zip----------
Home Tel----------------------------------------------Emerg
Tel-------------------------------------------
E-mail----------------------------------------------------------------------------------------------------------
2008 SPRING
& SUMMER CAMPS
Please check the session(s) you will
prefer :
q Session 1 - SPRING CAMP- @ WILTON - YMCA - Baseball Field
(APRIL 14 to 18, 2008, from 9:00AM
to 12:00PM for Ages 6 to 14, AGES 4 & 5 from 9:00 - 10:30 AM)
q Session 2- SUMMER CAMP @ WILTON-YMCA– Baseball Fields
(JULY
21 - 25, 2008 9:00 AM to 12:00 PM for AGES 6 TO 14; AGES 4 & 5 from 9:00 - 10:30 AM)
q Session 3- SUMMER CAMP @WILTON-YMCA Baseball Fields
(JULY
28 to AUGUST 1, 2008, AGES
6 to 14 from 9:00AM to 12:00PM ; AGES 4 & 5 from 9:00 - 10:30 AM)
Waiver
of Liability/ Emergency Authorization
To enable the YMCA, Town
of WILTON and Transylvania Gym & Soccer LLC to accept
registration and permit participation in the YMCA, Town of WILTON
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
YMCA,Town of WILTON and Transylvania Gym & SoccerLLC ,their
officers, directors instructors/coaches, and representatives from any claim
out for injury arising out of the YMCA,Town of WILTON and Transylvania Gym&SoccerLLC’s activities.
In
case of emergency I hereby authorize treatment and care of player by any
hospital, doctor, or emergency or ambulance association.
-------------------------------------------------------------------------------------------------------
Parent /Guardian Signature Date
Transylvania Gym & Soccer LLC
11 Grace Court
Bethel, CT, 06801
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