Please complete the registration for our Silicon Valley Soccer Academy College ID Camp

Parent Name *
Parent Name
Phone *
Player Name *
Player Name
Date of Birth *
Date of Birth
Emergency Contact *
Emergency Contact
Emergency Phone *
Emergency Phone
Camp Payment *
Player Waiver *
I, the Player, or parent/guardian of the minor Player, acknowledge that soccer is an inherently dangerous sport in which the Player participates at his/her own risk. I, for myself and the Player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the (1) U.S. Soccer, its affiliated organizations and its sponsors, (2) Silicon Valley Soccer Academy (SVSA), Palo Alto Soccer Club, Juventus Soccer Club, its officers, directors, coaches, team managers, volunteers, agents, representatives and assigns, (3) The City of Palo Alto and Redwood City and its subdivisions and all other organizations providing fields for play, including their agents, officers, directors, contractors, employees, representatives and assigns (collectively “Released Parties”), from and against all claims, liabilities, damages or causes of action arising out of or in connection with the Player’s participation in any and all SVSA programs. I affirm that the Player is in good physical condition. I understand that the SVSA does not carry medical insurance for Players participating in tryouts, practices, friendly scrimmages and other SVSA sponsored activities, and that I am responsible for the Player’s insurance coverage until the Player is officially registered as a Player with US Soccer.
Consent for Medical Treatment *
As the parent or legal guardian of the above-named Player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.
Electronic Signature *
Electronic Signature
Date *