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Brazilian Soccer in Okinawa, Japan
Brazilian Soccer Club Okinawa
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* SOCCER CLUB 2021
Welcome to Brazilian Soccer Club
The duration of the Fall Season is 4 months starting in September 6th to December 18th,2021.
PLAYER INFORMATION
*
First and Last name:
*
Player's Age:
8
9
10
11
12
13
14
15
*
Gender:
M
F
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
*
School Name:
*
How did you hear about our Soccer program:
Brazilian Soccer Club members
Brazilian SC website
Facebook
Instagram
AFN Radio
Friend
Email
Internet search
SOCCER CLUB INFORMATION
*
Soccer Program:
*Mon & Wed U12-U15 from 5:00-7:00pm and Sat from 11:00- 1:00pm
*Tue & Thur U9-U11 from 5:00 - 7:00pm and Sat from 8:00 - 10:00am
All payments are made at the office.
*
Soccer Club Fee:
*$600 ($150 per month) September through December
Uniform Information
If you are a new players you are required to get both practice and games uniforms, click both botton.
*Practice uniform (white jersey, blue short, blue socks, soccer ball, soccer bag)($120)
*Games uniform (Puma short, 2 puma jersey's and puma socks)($200)
*I don't need uniform
PARENT/GUARDIAN #1
*
First and Last name:
*
E-Mail:
Don't use " - " between the numbers
*
Cell Phone:
MEDICAL/EMERGENCY CONTACT INFORMATION
*
Emergency Contact Name:
*
Phone:
*
Relationship to Player:
WAIVER INFORMATION
*** I, as parent/guardian and undersigned, with legal responsibility for this participant states that he/she understands that the US military and or Brazilian Soccer Club organization, is not and shall not be responsible or liable for any illness to include COVID-19 or injury to the participant or person during activities. The undersigned will not hold the US military and or Brazilian Soccer Club responsible or liable for any damage to property resulting from participation or attendance of Brazilian Soccer Club activities.
I, as parent/guardian and undersigned, with legal responsibility for this participant, hereby forever releases and hold harmless the Brazilian Soccer Club, its employees, agents and representatives from any and all claims of any kind that the participant or the undersigned, or their respective heirs, executors, administrators or assigns may have or claim to have resulting from participation in any Brazilian Soccer Club activities.
Also, the undersigned and the participant authorize the Brazilian Soccer Club to use at its discretion, any photographs or videotape(s) taken of the participant while participating in Brazilian Soccer Club and waive any and all claims that the participant or the undersigned or their heirs, executors, administrators, or assigns may have or claim to have resulting from such photograph(s) or video tapes. I HAVE READ AND UNDERSTAND THE WAIVER STATEMENT, THE REGISTRATION INFORMATION. THE REGISTRATION IS NOT VALID WITHOUT A SIGNATURE. ***
I/we agree with the above
*
Signature:
Date:
* indicates required fields
