COPPELL FC camp registration & Payment

Oct 11, 9:00am-12:00pm | Andy Brown West

Register Coppell FC participants using the form below (U7-U15). When you click Submit you will be redirected to the payment portal.

Player 1 First Name

Player 1 Last Name

Player 1 Birth Year

Player 1 Gender

Player 1: Medical Conditions/Known Allergies:

Please list any medical conditions or allergies. If none, please write "None" or "N/A".

Player 2 First Name

If registering a second player, please input here.

Player 2 Last Name

If registering a second player, please input here.

Player 2 Birth Year

Player 2 Gender

Player 2: Medical Conditions/Known Allergies:

Parent Name

First Name

Last Name

Parent Email

Please provide the best email address to provide updates regarding the camp.

Emergency Contact Number

Please provide an emergency contact phone number for camp staff to contact a parent if need be.

RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that: I am aware there are risks to me of exposure directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable diseases, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS North Texas State Soccer Association, Inc. and its Member Associations, Clubs, and Leagues, as well as their respective officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any ILLNESS, INJURY, DISABILITY OR DEATH I or my child may suffer, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. This is to certify that I, as parent/guardian with legal responsibility for these participant(s), do consent and agree to his/her/their release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.