Please fill out the registration form below and submit it. If you have  questions contact Viktor @503-4340    First Name: Last Name: Parent/ Guardian Name: Age: Date of Birth: E-mail (REQUIRED): Day Phone Emergency Phone Home Address: Zip Code: Size: Youth SYouth MYouth LAdult SAdult M Select a Program: Super9 Academy U8-11Know-How SchoolSchool SelectAdvanced Academy U13-15                                                                         The Day/Time of the program that the player will attend: Medical Release Statement: I hereby authorize Super9 Staff to act for me according to their best judgment in any emergency requiring medical attention and authorize them to seek such medical attention as deemed necessary for the above participant(s). Therefore, I release, discharge and/ or otherwise indemnify the Super9 Soccer and its coaches, from any liability in the event of injury or illness suffered while playing in Academy/School or any other soccer activities organized by Super9 Soccer   I agree to the statement above      How did you hear about Super9 Soccer? Comments

***PLEASE NOTE: Commitment fees are non refundable.  However, credits may be applied to Super9 programs, camps, or clinics if approved by Super9 Soccer.