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Player Registration
Futsal OPEN Training MIDDLEBURG HTS 2024-2025
1
Complete Form
2
Payment
3
Confirmation
Option:
--Select--
Middleburg OPEN Training FULL (1-4) Oct 13-Mar 10
Middleburg OPEN Training 1, 3-5pm, Starts Oct 13
Middleburg OPEN Training 2, 3-5pm, Starts Nov 17
Middleburg OPEN Training 3, 3-5pm, Starts Dec 22
Middleburg OPEN Training 4, 3-5pm, Starts Jan 26
Price:
Description:
= Required Field
Player Information
--Select Player--
GENDER
Please select...
Male
Female
Coed
CITY
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
DATE OF BIRTH
-SELECT MONTH-
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FEB
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-SELECT YEAR-
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Age Group by DOB:
Select Month/Day/Year
SHIRT SIZE
--Select--
YS
YM
YL
YXL
AS
AM
BALL SIZE
--Select--
3
4
Approvals
In case of an emergency I hereby authorize the agent, officer or employee of Heart & Sole Futsal to act for me according to his/her best judgement. In any emergency requiring medical attention, and hereby waive and release agents, officers and employees, or the owner and operators of Heart & Sole Futsal from any and all liability for any injuries, illnesses, or loss of property incurred while attending the camp, course or tournament. Participants must inform Heart & Sole Futsal of any specific health needs. I also consent to the use by Heart & Sole Futsal and/or sponsors for promotional purposes in connection with this camp, tournament or coaching certification course of his/her name, address (city/state) and/or likeness and/or voice without further compensation. By electronically signing this, you agree to the statements above.
CONTACT INFORMATION
GUARDIAN #1
Same as player
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
ZIPCODE
1 of the 3 phone numbers below must be filled in
HOME
WORK
CELL
PREFERENCE
Home
Work
Cell
I would like to volunteer
Coach
Assist. Coach
Field Marshall
Referee
Team Manager
GUARDIAN #2 (optional)
Same as player
STATE
--Select--
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
ZIPCODE
1 of the 3 phone numbers below must be filled in
HOME
WORK
CELL
PREFERENCE
Home
Work
Cell
I would like to volunteer
Coach
Assist. Coach
Field Marshall
Referee
Team Manager
Add Another Player
CONTINUE
Refund Policy
Thank you for registering for one of the
Heart & Sole Futsal Winter Training
programs
.
You may cancel your registration up to one week prior to the start of the training session you have registered for and receive a refund of your fees
minus a $50 administrative fee
.
After one week prior to the program you have registered for, no refunds will be given. Special circumstances including relocation or injury will always be considered and players may always make up a class at another location throughout the session.
Contact Info
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