Registration Information: $120 Per Day (Select All 3 Days and Save $60)

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Select A Day(s) *
- April 21 - 5:00pm to 6:30pm
-$60.00 Discount will be updated automatically in Checkout *

Parent Primary Information

Full Name *
Phone *

Email *
Address *

City *
State *
Zip Code *

Emergency Contact Name(s) *
Emergency Phone Number(s) *

Player's Information

Full Name *
Age *
Due To Limited Space - What Level Is Your Player? *

Coach(es) that referred you to Alianza Sports Camps? *

How Did You Hear About Us? (if not coach referred) *
Any special needs we should know about(medical, dietary, behavior, etc.). *

Parent Authorization, General Release of Liability & Photograph and Video Authorization: I approve of my child participating in all activities at any of the Alianza Sports Camps and certify that s/he is in good health and is fit to participate. I understand that there are inherent risks in camp activities, which have been considered and which the Participant assumes. Participant has medical insurance and has had a health physical within the past year. I agree to hold harmless Alianza Sports Camps and its agents from claims or damages due to injury to person or property caused by act or failure to act by Alianza Sports Camps. I consent to emergency medical treatment for my child, if in the judgment of the camp staff it is required. I hereby authorize Alianza Sports Camps and its agents to publish the photographs and videos taken of me and/or the undersigned minor children, and our names, for use of training videos and to promote the success of our camps and players. I release Alianza Sports Camps and its agents from any expectation of confidentiality for the undersigned minor children and myself and attest that I am the parent or legal guardian of the children listed below and that I have the authority to authorize Alianza Sports Camps and its agents to use their photographs, videos and names in promotion and support of this event on Alianza Sports Camps and its agents Websites. I acknowledge that since participation in Alianza Sports Camps, I am agreeing to these terms, that neither the minor children nor I will receive financial compensation. This waiver has been read and understood and is electronically signed voluntarily by me as the legal representative for the participant. *
- I Agree

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Parent Primary Information

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