Tell us where you want to play Monday through Friday from 4:00-5:00.

Recognizing the possibility of injury or illness, accepting my son/daughter as a player in this soccer program, I consent to my son/daughter participating in the Play Where You Stay soccer program. Further, I hereby release, discharge, and otherwise indemnify Play Where You Stay, its related entities, sponsors, their employees, associated personnel, and volunteers, including the owner of fields and facilities utilized for the program, against any claim by or on behalf of my player son/daughter as a result of my son's/daughter’s participation in the program and/or being transported to or from the programs. I hereby authorize the transportation of my son/daughter to or from the program. I give my consent to have a coach and/or licensed medical doctor or dentist provide my son/daughter with medical assistance and/or treatment and agree to be financially responsible for the reasonable cost of any such assistance and/or treatment. I understand the program runs from 3:45-4:45 each weekday on school days. I accept the responsibility to have have my child walk home or receive a ride home at the end of the program (4:45) each day it is offered.

By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.