NJ Soccer Class Registration, New Jersey Soccer Class Registration

McLoughlin Sports - Soccer Class Registration Form

Child's Name:

Age:

DOB: Experienced 5 yr old (if applicable):

Class #1:

Session & Location:

Time & Day:

Class #2:

Session & Location:

Time & Day:

Child #2 Name (if appropriate):

Age:

DOB: Experienced 5 yr old (if applicable):

Class #1:

Session & Location:

Time & Day:

Class #2:

Session & Location:

Time & Day:

Parent/Guardian Name:

Telephone #:

Email Address:

Home Address:

Emergency Contact Name & Tel. #:

I certify the above named applican is emotionally ready, in good health and is given my permission to participate in this program. I understand that there is some risk in playing soccer and soccer related activities and I am willing to assume those risks. I certify that my child has no ailments or disabilities that would prevent my child from participating in McLoughlin Sports activities. I hereby agree to hold McLoughlin Sports Inc., its agents, employeees and contractors harmless from any and all claims for any injury or illness incurred by my child during participation in this program. In case of emergency, I grant my permission to have my child given emergency treatment at a local hospital. I also grant permission for any photographs taken of my child in the program to be used for future promotional use.

Parent Signature ______________________________________________________________ Date ______________

Registration Fee enclosed:
Discount:
Class Registration Total:

$ _____________
- _____________
$ _____________

I would like to order the following merchandise to be delivered to me the first day of class:

Quantity	Item, Price, Sizes Available	Sizes Needed
_____	Shin Guards ($10) XXS, XS, S	_____________
_____	Cleats ($20) red, unisex, youth sizes 9 - 13 1/2	_____________
_____	Starter Kit ($25) Ball, shin guards & bag	----------------------
_____	Soccer Kids Uniform ($30) Shirt, shorts & socks Tshirt: S, M, L Shorts: S, M, L	Tshirt ___________ Shorts ___________
_____	Soccer Kids Book ($12) by Tom McLoughlin	----------------------

Merchandise Total
$ _____________

Enclosed is my check for:

Class Registration & Merchandise Total
$ _____________

How To Register:
1.	Print this page
2.	Select the appropriate class for your child. Make a note of it for your personal records. Register immediately to get the class time you want. Enrollment is limited.
3.	Complete the application form. Be sure to check the box(es) and add $25 if you would like to purchase a Starter Kit, and/or $30 for a Soccer Kids uniform. Specify size for tshirt & shorts on form. (S, M, L)
4.	All registrants who are new to the program must enclose a copy of their birth certificate as proof of age. If your child is 5 years old and has previously taken classes, please check the appropriate box to aid with class groupings and content.
5.	REFUND POLICY: Please sign up only if your child is ready to participate in the class. Refunds are given only if we cancel a class. No refunds are given for registrants proven to be too young. A credit will be issued for withdrawals made no later than 48 hours before classes begin .
6.	Mail completed application form with check (made out to McLoughlin Soccer) to: McLoughlin Soccer 87 West End Avenue Somerville, NJ 08876
7.	No written confirmation will be sent. If you request confirmation, please enclose a self-addressed envelope.
8.	If a class is closed out, you will be informed immediately upon receipt of application.
Inclement Weather: In the event of poor weather on the day of class, please call (908) 393-5811, no earlier than one hour before the starting time to check if the class has been rescheduled.
Age: Your child must be the appropriate age by the first day of class. Birth certificate may be required as proof of age.
Refunds: Please sign up only if your child is ready to participate in the class. Refunds are given only if we cancel a class. No refunds for registrants proven to be too young. A credit will be issued for withdrawals made no later than 48 hours before classes begin.
Family Discount: $10 discount is available if registering a second child.