Zizo Soccer Programs Registration FormPlease enable JavaScript in your browser to complete this form.Name *FirstLastAge *Phone Number *Sex *MaleFemaleE-mail *Address CampsField CampGoal Keeping CampClub AffiliationJuly 23rd - 27thHalf DayFull DayFull Day / LunchAugust 13th - 17thHalf DayFull DayFull Day / LunchBoth weeksHalf DayFull DayFull Day / LunchEmergency Contact *FirstLastEmergency Contact Phone NumberPARENT/GUARDIAN CONSENT AND WAIVER *I hereby represent that the above information is true and accurate and the named applicant is in good health and has my permission to participate in the Zizo Soccer Programs. I acknowledge that soccer is a contact sport and that there is a risk of injury from participating in the camp and its related activities. I HEREBY WAIVE AND RELEASE Mohamed "Zizo" Sherif, Zizo Soccer Programs and its agents, servants and employees from any and all liability and claims for damages. In the event of an emergency I hereby give permission to such Medical personnel as necessary to render treatment.MessageSubmit
