Child's Name (Last/First/Middle)(required)Date of Birth(required)SchoolGradeParent(s) Name(s)(required)AddressCity, State, ZipParent's EmailParent's Phone(required)You will receive a confirmation email Insurance CompanyPolicy #Emergency ContactEmergency PhonePhysicianPhysician PhoneAllergiesMedical History (Include anything we should know about your child) I/We the undersigned have legal custody of the child mentioned above and have given consent for him/her to participate in the Torch Premier Soccer activities.Camps you would like to register for(required)June 24-28 Faith in SellersvilleParent's Name(required)I AgreeWAIVER I/We understand there are inherent risks in any activity, and I/we hereby release Torch Sport Ministry, its staff, and any volunteer working with us from any liability for any injury, loss or damage to person or property that may occur during the course of my/our child's involvement. In the event he/she is injured and requires the attention of a physician, I/we consent to any reasonable treatment deemed necessary by a licensed physician. I/We acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that treatment not be covered by the health insurance provider. Further, I/we affirm that the health and insurance information that I/we have provided is accurate. I also agree to bring my/our child home at my/our expense should they become ill or if deemed necessary by the camp staff.Parent's Name(required)I AgreeType the characters(required)Email address(required)NOTE: Upon submitting this registration, you will be redirected to the "COVID-19 RISK AGREEMENT" form. You must complete this form in order to complete your registration. You will recieve an email copy that you can print for your records.SubmitThis field should be left blank
