Registration Form Child's Name Parent's Name Address E-mail Address Phone Number Emergency Number Age by Camp Date Birthdate Camp Dates (Choose Any That Apply) 7/18 - 7/12 (West Caldwell NJ) 7/15 - 7/19 (Wayne NJ) 7/22 - 7/26 (Wayne NJ) 7/29 - 8/2 (Wayne NJ) Gender Boy Girl T-Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large Select Program Parent & Tot Pre-K & Kindergarten Youth High School Boot Camp Are You a PASCO Player? Yes No Which PASCO team? How did you hear about us? Please Read Carefully And Check the Box to Agree INSURANCE AND LIABILITY WAIVER Liability/Medical Waiver: My son /daughter is in good health and has my permission to participate in this program. In case of medical emergency, I authorize PASCO Soccer Club or Tuesta Soccer personnel to seek medical emergency care for my child. I hereby assume all risks and hazards incidental to my child’s participation in these activities, and I do hereby waive, release and absolve the PASCO Soccer Club or Tuesta Soccer assistants and participants from any claim arising out of injury to my child. I represent that I am a parent /guardian of the minor named above, and I agree that the grant and release contained therein binds me and the minor to all of its terms. I agree that photo’s taken of my child can be displayed on the PASCO Soccer Club or Tuesta Soccer website. Submit Name Phone Number Emergency Number Age (by camp date) Birth Date T-Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large Gender Boy Girl Camp Dates (can choose more than one if needed) 7/8 - 7/12 - West Caldwell 7/15 - 7/19 - Wayne 7/22 - 7/26 - Wayne 7/29 - 8/2 - Wayne Select Program Parent & Tot Pre-K & Kindergarten Youth High School Boot Camp E-mail Address Parent's Name Address Are you a PASCO Player? Yes No Which PASCO team? Where did you hear about the Camp? PLEASE READ CAREFULLY AND CHECK THE BOX BELOW IF YOU AGREE INSURANCE AND LIABILITY WAIVER Liability/Medical Waiver: My son /daughter is in good health and has my permission to participate in this program. In case of medical emergency, I authorize PASCO Soccer Club or Tuesta Soccer personnel to seek medical emergency care for my child. I hereby assume all risks and hazards incidental to my child’s participation in these activities, and I do hereby waive, release and absolve the PASCO Soccer Club or Tuesta Soccer assistants and participants from any claim arising out of injury to my child. I represent that I am a parent /guardian of the minor named above, and I agree that the grant and release contained therein binds me and the minor to all of its terms. I agree that photo’s taken of my child can be displayed on the PASCO Soccer Club or Tuesta Soccer website. Submit Name Phone Number Emergency Number Age Birth Date T-Shirt Size Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large Gender Boy Girl Camp Dates (can choose more than one if needed) 7/10-7/14 Wayne 7/17-7/21 Wayne 7/24-7/28 Wayne Select Program Parent & Tot Pre-K & Kindergarten Youth Adult Fitness Are you a PASCO player? Yes No E-mail Address Parent's Name Address Where did you hear about the Camp? PLEASE READ CAREFULLY AND CHECK THE BOX BELOW IF YOU AGREE INSURANCE AND LIABILITY WAIVER Liability/Medical Waiver: My son /daughter is in good health and has my permission to participate in this program. In case of medical emergency, I authorize PASCO Soccer Club or Tuesta Soccer personnel to seek medical emergency care for my child. I hereby assume all risks and hazards incidental to my child’s participation in these activities, and I do hereby waive, release and absolve the PASCO Soccer Club or Tuesta Soccer assistants and participants from any claim arising out of injury to my child. I represent that I am a parent /guardian of the minor named above, and I agree that the grant and release contained therein binds me and the minor to all of its terms. COVID-19: The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. It is believed that an individual can be in infected with COVID-19 without their knowledge and be asymptomatic. PASCO Soccer Club and Tuesta Soccer has put in place preventative measures to reduce the spread of COVID-19. However, PASCO Soccer Club and Tuesta Soccer cannot guarantee that I or anyone else will not become infected with COVID-19, including my spouse, guests, unborn child, or relatives. Participation in a PASCO Soccer Club and Tuesta Soccer athletic sports program(s), related event, or activity, could increase the risk of contracting COVID-19. By signing this agreement, I ACKNOWLEDGE the contagious nature of COVID-19 and VOLUNTARILY ASSUME THE RISK that I may be exposed to or infected by COVID-19 by participating in a PASCO Soccer Club and Tuesta Soccer athletic sports program(s), related event, or activity, and that such exposure or infection may result in personal injury, illness, permanent disability, and death to myself, my spouse, guests, unborn child, or relatives. I understand that the risk of becoming exposed to or infected by COVID-19 at a PASCO Soccer Club and Tuesta Soccer athletic sports program(s), related event, or activity may result from the actions, omissions, or negligence of myself or others, including, but not limited to, PASCO Soccer Club and Tuesta Soccer employees, volunteers, and program participants. I UNDERSTAND AND VOLUNTARILY ACCEPT AND ASSUME ALL the foregoing risks related to COVID-19 and accept sole responsibility for any injury or illness that may occur. Further, I UNDERSTAND AND AGREE that this release includes any Claims based on the actions, omis-sions, or negligence of PASCO Soccer Club and Tuesta Soccer , its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any PASCO Soccer Club and Tuesta Soccer athletic sports program(s), related event, or activity. Photo Release: I agree that photo’s taken of my child can be displayed on the PASCO Soccer Club or Tuesta Soccer website. (If you do not want your son or daughter's image posted on the website, please contact us at [email protected]) Submit