[[[["field8","greater_than","2012-01-01"]],[["show_fields","field39"]],"and"],[[["field40","equal_to","1"]],[["show_fields","field3,field1,field6,field8,field19,field20,field39"]],"and"],[[["field40","equal_to","2"]],[["show_fields","field3,field1,field6,field8,field19,field20,field44,field42,field46,field47,field50,field52,field56,field43,field39"]],"and"],[[["field40","equal_to","3"]],[["show_fields","field43,field3,field1,field6,field8,field19,field20,field44,field42,field46,field47,field50,field52,field56,field57,field41,field48,field45,field49,field51,field55"]],"and"],[[["field40","equal_to","1"]],[["set_value",null,"300",null,"field30"]],"and"],[[["field40","equal_to","2"]],[["set_value",null,"400",null,"field30"]],"and"],[[["field40","equal_to","3"]],[["set_value",null,"500",null,"field30"]],"and"],[[["field40","equal_to","==Select An Option"]],[["show_fields","field40"]],"and"]]
1
SEZON 2017 / 2018 ( indoor )
Who Recommended You to Our Program?full name

First Child

First NameImię
Last NameNazwisko
Birth DateData urodzenia
Medical Information / AllergiesChoroby dziecka / kontuzje
0 /
Soccer Experience (if any)Doświadczenie
0 /

Second Child

First NameImię
Last NameNazwisko
Birth DateData urodzenia
Medical Information / AllergiesChoroby dziecka
0 /
Soccer Experience (if any)Doświadczenie
0 /

Third Child

First NameImię
Last NameNazwisko
Birth DateData urodzenia

Przepraszamy. Nie przyjmujemy obecnie dzieci urodzonych po 2012 roku.

Medical Information / AllergiesChoroby dziecka
0 /
Soccer Experience (if any)Doświadczenie
0 /

Parents Information

Full Name of Both ParentsImiona i nazwiska rodziców
Mother's Phone numberNumer telefonu
Father's Phone numberNumer telefonu
Full AddressAdres zamieszkania
0 /
Waiver / Release *
I am aware of the dangers involved my child's participation in the physical activities of the FC Polonia Edmonton Soccer Camp and all activities related to the camp; these activities include, without limitation, practices and events. I am aware that the FC Polonia Edmonton Soccer Camp involves competition with and against other camp participants and that such participation may involve physical contact. With regard to such physical activity, I am aware that there is inherent danger and risk of injury. I also am aware that many of these injuries may be serious and may include, without limitation, damages to joints, ligaments, muscles, bones, neck, spine, and other parts of the body. Further, I am aware that activities related to the camp will involve the use of certain equipment. I am aware that such equipment in no way guarantees my safety from injury. Additionally, said equipment must be used in a proper manner; therefore, my child will follow any and all instructions related to the use of equipment. My child's participation in the above events and in all activities related to the above events is a voluntary act with full and complete knowledge of the risks involved. I hereby voluntarily assume all such risks associated with my child's participation in the above events. In the case of an emergency, I authorize any treatment deemed necessary from a first responder, physician or hospital for the immediate care of my child. Additionally, I agree to exonerate, save, indemnify, and hold harmless the FC Polonia Edmonton Club, their officers, agents, employees, and volunteers from any and all liability, claims, causes of action, or demands of any kind and nature whatsoever, including without limitation personal injury which may arise from or in connection with my participation in any activities related to the camp. The terms hereof shall serve as a release and assumption of risk for my child, my heirs, estate, executor, administrator, assignees, and all members of my family. I have read and understand this acknowledgment and release and execute it as a free and voluntary act. Further, this acknowledgment and release is contractual and not a mere recital.
ItemsQtyTotal
FC Polonia Edmonton Soccer Camp1[field30]
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