Questionaire

College Cup Youth Clinic Registration

NCAA Men's College Cup Youth Soccer Clinic FREE event!!!

When:

December 15th
Registration from 9:00-9:30am
Clinic from 9:30am-12:45pm

Where:

SAS Soccer Park, Cary, NC

Who:

Girls and Boys, ages 8-16

Clinic Highlights

*Receive offensive and defensive skill instruction from NCAA coaches and student-athletes.
*Discover essential life skills for student-athletes.
*Learn conditioning tips to help elevate your game.
*Parent panel discussion on parenting student-athletes.
*Receive a FREE voucher to attend the Men's College Cup Championship game--Sunday, December 16, 3p.m.
*Stay and see the U.S. A. Paralympic team play a match at 1p.m.!!

REGISTRATION

Registration is limited to ensure effective group instruction. Early enrollment is encouraged. Girls and boys ages 8-16 are invited to participate.
All applications must be signed by a parent or guardian. Confirmation will be sent by letter on a first-come, first-serve basis.
ALL PARTIPANTS SHOULD WEAR ATHLETIC CLOTHES AND SHOES AND DRESS FOR OUTDOOR ACTIVITY.

Required Fields in Bold

First Name

Last Name

Male or Female

	M
	F

Address

City

State

Zip

Birth Date

Grade in School

Parents First Name

Parents Last Name

Emergency Contact Phone #

E-Mail

				In the event of an injury to my child, I agree that North Carolina State University, SAS Park, Brine and/or the NCAA is authorized on my behalf to obtain any medical care or treatment deemed necessary. I also hereby release the entities stated above, its employees, directors, members, agents, volunteers, and officers from any and all liability alleged to be caused in whole or in part by their negligence. I further agree to allow my child's likeness to appear in materials promoting NCAA Youth Clinics, including but not limited to NCAA website. PARENT/ GAURDIAN DIGITAL SIGNATURE REQUIRED.
				

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