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WHERE TECHNOLOGY MEETS SOCCER
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MEMBERSHIP
WAVIER
& RELEASE
Player First Name
Player Last Name
Date of Birth
Guardian First Name
Phone
Guardian Last Name
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Do you permit your child to participate in intense physical activities?
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I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
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