Child's Name:

Gender:

Date of Birth:

Parent/Guardian's Name:

Address:

City/State:

ZIP:

Phone:

Email:

$20 Registration donation includes clinic T-shirt, soccer ball and snacks (for online donation, see left)

T-Shirt size:

Starting June 20, only T-shirt sizes available are Youth Medium, Youth Large, and Adult Small. Please register for one of these sizes.
Currently, we are out of T-shirts, but have more ordered to arrive the week of the clinic.

Experience Level:

Emergency Contact:

Emergency Contact Phone:

Statement of liability and use:
I am an adult over 18 years of age and wish to have my child participate in Crosswind activities. I give my child permission to participate in the Crosswind Soccer Clinic. I understand that even when every reasonable precaution is taken, accidents can sometimes happen. Therefore, in exchange for allowing my child to participate in the Crosswind Soccer Clinic, I understand and expressly acknowledge that I for myself, or anyone entitled to act on my behalf, waive and release Crosswind, sponsors, representatives and successors from all claims or demands arising out of any such injuries or losses. I understand that this release includes any claim based on negligence, action or inaction of CrossWind, its staff, members and guests.
I have read and understand and voluntarily signing this authorization and release.
I understand that CrossWind is not responsible for personal property lost, damaged or stolen while participating in a CrossWind event.
I give my permission to CrossWind to use limitation and obligation, photographs, film footage or tape recordings with may include my or my child's image or voice for the purposes of promotion or interpreting CrossWind events.