Offline Registration

If you are having difficulty submitting an online request for a class or camp then you can use this form to submit a request directly to the registrar. Please note your registration will not be confirmed until you hear back from the registrar.

Class:	Please describe the class you wish to join including location and time.
Participant Name:
Participant Age (years):
Participant Gender:
Parent Name:
Address:
City:
State:
Zip Code:
Phone:
Email Address:
Friends: (List any friends you would like on your team)
Medical: (List any medications or medical conditions)

Medical Release Consent
I, the guardian of the registrant, a minor, recognize the possibility of injury associated with soccer. I hereby release, discharge and/or otherwise indemnify Strictly Soccer, its affiliated organizations, sponsor and personnel, including fields and facilities. I authorize any medical procedures if I cannot be reached in case of an emergency. Strictly Soccer and it's associated facilities does not assume responsibility for any accidents or other expenses incurred as a result of attendance of this event. The applicant is physically fit to participate in soccer activities and is covered by health or accident insurance.
By entering my name and date below I agree to the provisions of the above 'Medical Release Consent'.
Parent Signature:
Date: