On line Application Form

Fall soccer online application form.

Child's Name :
Birth Date:
Address:
City:
State:
Zip:
Gender:	Male Female
Parent's Name:
Home Phone:
Email Address:
Parents participation	Parents participation:
Note:	The amount of $35.00 will be applied if parent (s) can not assist with the program!
Medical Consent: I hereby state that my child is in good normal health, and has my permission to participate in any and all activities offered by the Players Club of Tampa Bay. In addition, I authorize The Players Club and its staff to act for me in securing medical treatment for my child in the event of injury or illness. I understand that I am responsible for all hospital, x-ray, laboratory and others fees associated. I also agree that in case of an accident involving my child, while attending any activities, that The Players Club and its staff, The Hillsborough Park and recreation department and its staff are released from any and all liability.
Parents Signature:
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