Curt Onalfo Soccer Summer
Residential Training Program

Registration and Waiver Form

Parents or Guardian: Please complete this application, print and mail it with your payment to the address below. Each application MUST BE SIGNED by a parent or guardian before it will be accepted. Please make sure to circle the package number of the session your child will attend.

The Sessions Listed Below are Currently Available for Registration
Session	Type	Location	Dates	Times	Cost
1	U9-U19 travel Indiv. & teams	Foxcroft School (Middleburg)	Sun Jul 6 to Fri Jul 11	Residential	$599
2	U9-U19 goalkeepers	Foxcroft School (Middleburg)	Sun Jul 6 to Fri Jul 11	Residential	$599
3	U9-U19 travel Indiv. & teams	Foxcroft School (Middleburg)	Sun Jul 6 to Fri Jul 11	8:45 AM to 8:00 PM	$409
4	U9-U19 goalkeepers	Foxcroft School (Middleburg)	Sun Jul 6 to Fri Jul 11	8:45 AM to 8:00 PM	$409

*There is a 10-player minimum for travel teams. For more information, including team discounts, please visit www.teamcos.net or contact us at jim@teamcos.net or 571-331-3608.

Location: All sessions take place at Foxcroft School in Middleburg, VA (20 minutes west of Dulles International Airport). Space is limited to 200 participants per session and applications will be accepted on a “first come, first served” basis. Check-in is between noon and 2 PM on Sundays. We plan to train the first day. Check-out is between noon and 2 PM on Fridays, although we invite you to attend our closing ceremony at 11 AM. Please contact us in advance in the event you are unable to arrive or depart within these times.

Equipment: All participants must bring ball, appropriate soccer attire, including cleats, indoor soccer or tennis shoes, and shin guards. Each participant must provide his/her own bed sheets, towels and toiletries as well as a bathing suit if they plan to swim. Additional drinks, snacks including pizza, and soccer gear will be available in our on-site store. We will send a list of suggested items to bring, driving directions and on-site contact information via email upon receipt of your final payment. Reserve your spot by completing this form and returning it with your non-refundable deposit of $100. Early-Birds please note registration must be paid in full by expiration date to receive published discount(s). Refund Policy: The deposit is NON-REFUNDABLE and non-transferable regardless of the reason for cancellation. Other monies paid will be refunded only upon written request and if cancellation is made at least two weeks prior to the first day of the session. After that time, no refunds will be made for any reason. Final payment must be made at least one month prior to the first day of the session.

Valuables: We will not assume any responsibility for valuables brought to the program. Any photographs or videos taken during the sessions of participants may be used at the discretion of Curt Onalfo Soccer, Inc. By submitting this form you agree with these terms. Parents or Guardian: Please register online on our secure server at www.teamcos.net or complete this application and mail it with your payment to the address below. A parent or guardian MUST SIGN each application before it will be accepted. Please make sure to CIRCLE the package you will attend on the portion above.

Team Name (required: please include league and division)
Participant's Name
Participant's Gender	Female Male
Address
City
State
Zip

Primary Parent/Guardian Info
First Name / Last Name	/
Home Phone (including area code)
Work Phone
E-mail Address (Mandatory for Confirmation)
Second Parent/Guardian Info
First Name / Last Name	/
Home Phone (including area code)
Work Phone
E-mail Address (Leave blank if same as Primary Parent/Guardian E-mail address)

Requested Roommate(s) (up to 3, space permitting)
How did you hear about the summer program?
T-shirt Size	Child: Sm. Med. Lg. XL Adult: Sm. Med. Lg. XL

Age (as of today)		Date of Birth
Requested Roommate(s) (up to three, space permitting)

Insurance Carrier
Policy Number
Medical Conditions We Should Be Aware Of
Emergency Contact and Phone Number if parent or guardian is not available

Please note our Refund Policy: To guarantee your space, program session must be paid in full. Registration fee(s) will be refunded only upon written request and if cancellation is made at least 30 days before the first day of the session. There is a non-refundable $50 administrative fee subtracted from any refund. Injury policy: Due to the potentially dangerous nature of soccer, whch is a contact sport, we cannot refund any fee(s) due to player injury, whether as a result of soccer training or otherwise. We reserve the right to modify this policy at any time.

If Paying By Credit Card: Please Circle Card Type: Visa MasterCard

Amt. To Be Charged: $________________ 16-Digit Acct. #: ______________________________

3-digit security code (last four digits on signature panel of card after card #): _____________________

Exp. Date (mm/yy): _____________ Please Print Name Of Cardholder: ______________________

Signature (Required for credit card): ________________________________________________

Please mail payment and form to (if paying by check, please make payable to Curt Onalfo Soccer):

5717 Waters Edge Landing Ct.
Burke, VA 22015

CONSENT, RELEASE AND AUTHORIZATION

I am the parent or guardian of the above named child (the “player”). I consent to the participation of the player in soccer-related programs operated by Curt Onalfo Soccer, Inc., including but not limited to training sessions, practices, games, and tournaments. I understand that the such programs are hazardous by their nature, and I assume all risk of injury or death arising from such activity, and accordingly I release, indemnify and agree to hold harmless Curt Onalfo Soccer, Inc., and the owner and operator in which the applicable program is located, and their respective directors, officers, employees, sponsors, counselors, and staff from any claim, suit, demand, or action arising in connection with the player’s participation in programs operated by Curt Onalfo Soccer, Inc. I further assume all responsibility for all transportation to and from such programs. If the player requires medical attention in the judgment of the supervisor of any program in which the player is participating, and the player’s parent or guardian or emergency contact cannot be reached after reasonable efforts to contact them (it being understood that no such efforts are required in case of emergency) the undersigned hereby authorizes such supervisor or a representative of Curt Onalfo Soccer, Inc., to obtain and authorize medical treatment for the player.
I HAVE CAREFULLY READ THE ABOVE CONSENT, RELEASE AND AUTHORIZATION AND FULLY UNDERSTAND ITS CONTENTS. I UNDERSTAND THIS IS A RELEASE OF LIABILITY AND I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT VOLUNTARILY.

Signature: ________________________________________________________________________________
Relationship: __________________________________ Date: ______________________________________

Curt Onalfo Soccer Summer Residential Training Program

Registration and Waiver Form

Curt Onalfo Soccer Summer
Residential Training Program