Player First Name:____________________           Player Last Name:___________________

Date of Birth:________________________          Parents Name:______________________

Home Phone:________________________          Email Address:______________________

Mobil Phone:________________________           Work Phone:________________________

 

Known allergies or other medical problems__________________________________________

 

I agree that in no event will AFUSA be held liable for any injures, accidents, or losses suffered by my child while participating in any supervised training and AFUSA is herby released from liability.

 

______________________________

           (Parent Signature)

 

Fee: $150.00 due with Registration Form. Fee covers 10 sessions hosted every Sunday from August 21^st to October 30^th.  No Session on September 4^th.  Each player will also receive one (1) training shirt. Training shirt sizes: YS, YM, YL, AS,AM,AL.

 

Location:  George Pierce Park, Field #14

 

 

Time:  4:30 PM to 5:30 PM

 

Make Check Payable to:  AFUSA

 

Send Check to:    Keylor Reyes

                           6008 Tree-Summit Pkwy

                           Duluth, Ga, 30096

 

Contact Information: keylor08@hotmail.com    (404) 542-4207