Footy Tots Registration

Participant Name: Date of Birth:

Player Size:

Please select which session(s) you would like to participate in: Saturday 10:00am - 10:45am (spaces available) Saturday 11:00am - 11:45am (waiting list)

Does the participant have any medical illness such as asthma? Yes No

If 'Yes' please describe medical condition

Please note that it is your responsibility to let us know if the participant has been exposed to Covid-19 or is a close contact with someone in their household or school at anytime during this event.

Parent or Guardian: Home Phone: Cell Phone: Email Address:

Registration Fee:
$190.00

Would you like to purchase Footy Tots tracksuit? ($50) Would you like to purchase Footy Tots Parent T-shirt? ($20)

Pay By: Direct Deposit Cash Check

Participation includes possible exposure to and illness from infectious diseases including but not limited to influenza and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness does exist.

I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation; and,

I willingly agree to comply with the terms for participation in regards protection against infectious diseases. If, however, I observe and any significant hazard during my presence or participation, bring such to the attention of an official.

By submitting this form, you hereby agree that Footy Promotions / Footy Force Futsal, its members, coaches or officers, shall not be liable for any and all illness, disability or injury

or loss which my child or children may sustain while participating in activities of any kind, whether sponsored by or under the supervision of the Footy Promotions / Footy Force Futsal.

We agree to indemnify and to hold harmless Footy Promotions / Footy Force Futsal, its members, coaches, officers or designates from any kind of claim whatsoever.

The Participant, and the Parent(s) or Guardian(s), if the Participant is a minor child, grant authorization to Footy Promotions / Footy Force Futsal

to use photographs of the Participant for publicity purposes including Website, social media and print advertising content.

Parent or Guardians Please Inital Here To Sign: Date:

Please note that there are no refunds once the participant has started the Footy Tots Program sessions

In the case of inclement weather conditions, we will always make a decision we feel is in the best interest of the safety of all players, parents and coaches. These conditions may be deemed unplayable and will require your scheduled session to be canceled or postponed. If your classes are impacted by inclement weather, we will reschedule up to one canceled session and extend the time on the remaining classes.