Player Registration

Futsal OPEN Training MIDDLEBURG HTS 2024-2025

    
1Complete Form

Option:  

Required  Price: 
Description: 
 = Required Field

 Player Information

 
 
 
 
  Select Month/Day/Year
 
 


 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

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 
GUARDIAN #2 (optional)

 
 STATE 
 ZIPCODE 
 1 of the 3 phone numbers below must be filled in
 HOME 
 WORK 
 CELL 
 PREFERENCE 

 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