Player Registration

ISC Fall 2017 Academy for 4-6 Year Olds

Option:  

Required  Price: 
Description: 
 = Required Field

 Player Information

 
 
 
 
  Select Month/Day/Year
 
 Emergency Contact 
 Emergency # 
Comments 
 How did you hear about the academy? Required

 Approvals

I hereby release the Iowa Soccer Club Inc., and all associates, employees, volunteers, officials, and agents associated with this program and facility from any and all claims, liabilities, loss of services, and cause of action of any kind for personal injury and property damage arising in any way out of participation. I hereby authorize the supervisors of the ISC Academy to act for me according to their best judgment in an emergency requiring medical attention. My son/daughter is fully covered by our personal family health plan in the event of injury or sickness.

 CONTACT INFORMATION

GUARDIAN #1

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

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

 Refund Policy

 Contact Info