General information
Family Name	* required
Address number	* required
Street	* required
City	* required
State	* required
Zip	* required
Home telephone	* required
Emergency telephone	* required
Email	* required
Registration player 1
Name	* required
Date of Birth	* required
Age	* required
Gender	* required
Camp/Clinic location	* required
Camp/Clinic code	* required
Registration player 2 (if applicable)	* required
Name
Date of Birth
Age
Gender
Camp/Clinic location
Camp/Clinic code
Payment method Please tick appropriate box
I would like to pay online. Please proceed to Payment on the main menu bar upon completion of your registration. We will do the rest!
I enclose a check for the full amount made payable to Kickz Soccer UK along with a complete d registration form. Please send these to Kickz Soccer UK, PO Box 723, Chatham, New Jersey, 07928.
Please inform us of any medical conditions that our staff need to be aware of
I hereby agree too let my child participate in the sporting activities on this camp or program. I understand that there are risks of injury inherent in the practice and play of soccer and related activities. I certify that there is no medical or physical condition that would prevent my child from participating in these sports activities. In addition to giving full consent of my child’s participation on the camp, I do waive, release and hold harmless Kickz Soccer UK, its coaches, trainers and representatives for any injury that may be suffered by my child in the normal course of participation and activities incidental thereto, whether a result of negligence or any other cause. I grant permission to Kickz Soccer UK to use photographic images of my child in future promotional materials. Merchandise maybe sold at camps. Promotional material may be handed out on camps. Players should wear appropriate clothing, soccer cleats or sneakers must be worn. It is recommended that players have shin guards and goalkeepers wear appropriate gloves. It is recommended that players bring a light snack and plenty of water. Your cancelled check is confirmation that your place has been registered, if the class is full, your check will be mailed back to your address. If you require additional confirmation please send a S.A.E. Refunds will not be issued in the event of non participation. A $25 fee will be charged for cancellation and refund requested. A credit voucher for a full registration fee is available in place of a refund. No refunds or credits will be given once the camp has started. Cash refunds will not be given in the case of bad weather, pro rated credit vouchers may be available. I have read the above release information and I agree to the terms and conditions as stated by clicking yes to submit via email or by signing below if submitting via postal registration.
Signed: