Soccer for Kids Online Registration

2018 Summer Session: June 2 – August 12, 2018 (Registration deadline: May 15, 2018)

Steps for online registration:

  1. Review the consent and waiver forms below (must be signed on first day).
  2. Please fill out and submit the form below.
  3. Pay registration fee (Enter player’s name and click Pay Now button at the bottom of this page – payments are processed via Paypal. You can use your Paypal account or use any debit/credit card to make the payment)
  4. You will receive email confirmation for your payment from Paypal. Please save the email as proof of payment.
  5. Someone from our team will contact you within 24 hours after the form submission and payment are received.

Online Registration Form


MaleFemaleOther


I Agree










Call us at 469-288-0634 if you have any questions about making online payment.


As the parent or legal guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are Necessary to preserve the life, limb or well being of my dependent.

Parent/Legal Guardian (please print)
Name: ____________________________________
Signature: X _______________________
Date: ___________________________________________


PARTICIPATION WAIVER FOR MINORS:

I _____________________ hereby acknowledge that I am the parent/ legal guardian of ____________, who is a minor under the age of eighteen (“Minor Child”). In consideration for the benefits to be derived from My Minor Child’s participation in a “SOCCER FOR KIDS” program for soccer training, I, on behalf of myself and my Minor Child, hereby acknowledge the following: (1) I am aware that all Sport (soccer) training and/or playing involve risk, which is contact sport; (2) I am aware that playing or practicing in soccer will might be a dangerous sometime involving MANY RISKS OF NJURY; and (3) I UNDERSTAND THAT THE DANGERS AND RISKS OF PLAYING OR PRACTICING IN SOCCER TRAINING SESSIONS OR/AND GAME/S INCLUDE, BUT ARE NOT LIMITED TO DEATH, SERIOUS FRACTURES, WHICH MAY RESULT IN COMPLETE OR PARTIAL PARALYSIS, BRAIN DAMAGE, SERIOUS INJURY TO VIRTUALLY ALL INTERNAL ORGANS, BONES, JOINTS, LIGAMENTS, MUSCLES, TENDONS, AND OTHER ASPECTS OF THE MUSCULAR SKELETAL SYSTEM AND SERIOUS INJURY OR IMPAIRMENT TO OTHER ASPECTS OF MY MINOR CHILD’S BODY, GENERAL HEALTH, AND WELL-BEING.

On behalf of my Minor Child, and myself I further understand and acknowledge that the dangers and risks of playing or practicing during the practice sessions or/and games may result not only in injury, but serious impairment of my Minor Child’s future abilities to earn a living, to engage in other business, social, and recreational activities, and generally to enjoy life.

Because of the danger of participating in the above sport, I, both on my own behalf and on behalf of my Minor Child, acknowledge and understand the importance of rules and regulations established by Dallas Gurkhas Football Club as the founder of this “SOCCER FOR KIDS” program. My minor child hereby agrees to obey such rules, regulations, and instructions.

I further acknowledge that my Minor Child is in good physical condition and do not know of any condition or reason that my Minor Child should not participate in Soccer training and matches.

I RECOGNIZE AND ACKNOWLEDGE THAT THE DALLAS GURKHAS FOOTBALL CLUB, SPONSORS, AND COACHES DO NOT CARRY ANY TYPE OF ACCIDENT OR HEALTH INSURANCE POLICY ON THE PARTICIPANTS IN SOCCER ACTIVITIES. I ALSO REALIZE THAT SPORTS INJURIES CAN BE CATASTROPHIC FOR THOSE WITHOUT PROPER
MEDICAL COVERAGE.

Registration Fee: $100.00 – (this DOES NOT includes insurance). Registration Fee is not refundable
A copy of birth certificate or other proof of age is required.

I HAVE READ THIS AGREEMENT, UNDERSTAND THAT I AM GIVING UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND AGREE INDIVIDUALLY AND ON BEHALF OF MY MINOR CHILD TO BE BOUND BY IT.

Parent/Legal Guardian (please print)
Name: ____________________________________
Signature: X _______________________
Date: ___________________________________________