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Player Information
First Name
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Last Name
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Date of Birth
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Gender
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Male
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Jersey Size
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YS
YM
YL
AS
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AL
AXL
Preferred Position
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Forward
Midfielder
Defender
Goalkeeper
No Preference
Age Group / Program
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U6 (Ages 4-5)
U8 (Ages 6-7)
U10 (Ages 8-9)
U12 (Ages 10-11)
U14 (Ages 12-13)
U16 (Ages 14-15)
U18 (Ages 16-17)
Prior Experience
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Beginner
1-2 Years
3-5 Years
5+ Years
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Parent / Guardian
First Name
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Last Name
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Email Address
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Phone Number
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Home Address
Emergency Contact Name
*
Emergency Contact Phone
*
Relationship to Player
Session Preferences
Preferred Training Days
MON
TUE
WED
THU
FRI
SAT
SUN
How did you hear about HEITS?
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Social Media
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Additional Comments or Questions
Liability Waiver & Consent
I, the undersigned parent/guardian, hereby enroll the above-named player in HEITS Soccer Academy programs and activities. I acknowledge that participation in soccer involves inherent risks of physical injury and agree to release HEITS Soccer Academy, its coaches, volunteers, and affiliates from any liability for injury or loss arising from participation, except in cases of gross negligence. I consent to emergency medical treatment if necessary and grant HEITS Soccer Academy permission to use photographs or videos of the player for promotional purposes. I confirm that all information provided is accurate and that the player is physically fit to participate. This waiver remains in effect for the duration of enrollment.
I have read and agree to the liability waiver and consent on behalf of the registered player.
*
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Entries are sent directly to matt@heitsacademy.com