PARTICIPANT'S NAME *
PARTICIPANT'S NAME
BIRTHDATE *
BIRTHDATE
CURRENT ADDRESS *
CURRENT ADDRESS
Phone *
Phone
MOTHER'S NAME
MOTHER'S NAME
FATHER'S NAME
FATHER'S NAME
ELECTRONIC SIGNATURE *
ELECTRONIC SIGNATURE
I, the parent or legal guardian of the child named above who is participating in Cheetah Cub Academy with Three Rivers Soccer Club, hereby give authorization for my child to participate in the program. I agree to release and discharge the TRSC and its affiliates and further waive the right to initiate a cause of action for any and all liability, by reason of injury to named player, while participating in the program.
TODAYS DATE *
TODAYS DATE

PAYMENT:

WE ASK THAT ALL PARTICIPANTS PAY THE FIRST DAY OF THE CHEETAH CUB ACADEMY UPON ARRIVAL. WITHOUT PAYMENT YOUR SON/DAUGHTER WILL NOT BE ABLE TO PARTICIPATE.

THERE WILL BE A TABLE SET UP TAKING CHECK OR CREDIT/DEBIT PAYMENTS. 

IF PAYING CHECK PLEASE MAKE PAYABLE TO: THREE RIVERS SOCCER CLUB

TOTAL: $125