winter2010.html

FUTSAL - Online Registration Form Fall 2010 - Winter 2010/11 Indoor Soccer Training
For enrollment please fill out the following information and press the REGISTRATION button. To pay by *CHECK* send us your check payable to:
Soccer The Brazilian Way (STBW) 8905 Clewiston Place Montgomery Village, MD 20886
We also accept the following credit cards:				You will be given the option of paying with a credit card after registering
Futsal is a form of indoor soccer that requires quickness, vision and excellent ball skills. More on Futsal Training

Clinic Fee per Player :	Individual	Teams	Teams have preference over age groups.
Normal sessions (1-1/2 hours):	$195	$175	You can select any session for a team.
Extended sessions (2 hours):	$215	$195	A minimum of 14 players is required for a team discount
			Don't forget to enter the team name when registering
Cancellation / Refund Policy: All cancellations must be received in writting 15 days prior to your first session date to qualify for a refund, less $25 administrative fee.

Full Name (Last, First):	*
Address (Street):	*
City:	* State: Zip : *
Home Phone:xxx-xxx-xxxx	- - * Email Address: *
Cell Phones:xxx-xxx-xxxx	- - - - - - - - - - - - IMPORTANT!
Date of Birth (mm/dd/yyyy):	* Age: Gender:****
Team (optional) :	* Discount Coupon: *
I accept full responsibility for the use of the facilities at my own risk, and shall hold Soccer the Brazilian Way, its employees, as well as the Facility's owners and operators and its employees and staff harmless from any and all loss, claim, injury, damage or liability sustained or incurred by the minor resulting therefrom. In the event of an emergency, parents (or depending of the circumstances Emergency-911) will be notified first. I understand the importance of providing phone mumbers where either one of the parents or guardian can be easily located during camp or training hours. I agree that Soccer the Brazilian Way staff will not held responsible for any accident or losses, however caused, and agree to release all parties involved from claim of damages that may arise as a result or by reason of such loss or accident. I understand that every reasonable precaution will be taken to ensure the safety of the above named participant.
Allergies-Medications:	Please email us any special needs or precautions the minor may require.
Acceptance of conditions: By writing my name and date above I represent to be the parent or guardian of the minor.
Parent or Guardian Full Name:	* Date: *
* = Required