3 vs. 3 SPRING LEAGUE
REGISTER YOUR TEAM OF FOUR PLAYERS OR SIGN UP
AS A SINGLE PLAYER AND BE PLACED ON AN AGE
APPROPRIATE TEAM. REGISTRATION FEE IS $60 PER
TEAM OR $20 AS A SINGLE PLAYER
Authorize my son/daughter full participation in The University of HoustonVictoria Soccer 3 vs 3 League, including all related soccer activities. It is my
understanding that participation in the activities at The University of
Houston-Victoria 3vs. 3 Soccer League is not without the inherent risk of
injury.
OPEN TO BOYS AND GIRLS AGES 4 -17. BOYS WILL
PLAY TUESDAY EVENINGS AND GIRLS WILL PLAY
THURSDAY EVENINGS. HIGH SCHOOL AGED PLAYERS
PLAY ON THURSDAY NIGHT TO AVOID CONFLICT WITH
HIGH SCHOOL GAMES
ADULT LEAGUE 18 YEARS OLD AND UP. MEN’S TEAMS
WILL PLAY TUESDAY EVENINGS AND WOMEN’S TEAMS
WILL PLAY THURSDAY EVENINGS
In consideration of my son’s/daughter’s participation in The University of
Houston-Victoria 3 vs. 3 Soccer League , I hereby release, waive, discharge
and agree not to sue the league, the Athletic Department, the University of
Houston, the University of Houston-Victoria, the University of Houston
system, the State of Texas, their officers, servants, agents, or employees
from any and all liability, claims, demands, action and clauses of action
whatsoever arising out of or related to any loss, damage or injury, including
death, that may be sustained by my son/daughter, whether caused by
negligence of the releases, or otherwise while participation in such activity,
or in, or upon the premises where the activity is taking place.
EMAIL UHV HEAD COACH ADRIAN RIGBY AT
[email protected] FOR REGISTRATION FORM OR CALL
361-485-4418 FOR MORE INFORMATION REGARDING
THE 3 vs. 3 LEAGUE
I hereby give my permission for any emergency treatment or medical care
by a physician, hospital or medical facility that may be required, including
transport, during the specific UHV 3 vs. 3 Soccer League that my
son/daughter is in attendance.
REGISTRATION FORM
(IF YOU SIGN UP AS A TEAM OF FOUR, EACH
PLAYER MUST COMPLETE A WAIVER FORM)
Team or Single Registration:____________________________
3vs. 3 Team Name:______________________________________
BOYS & GIRLS (AGES 4 -17)
(COMPETITION BASED ON AGE)
ADULT (18+)
(MEN’S AND WOMEN’S TEAMS)
TH
Furthermore, I will be solely responsible for any and all costs of medical
attention and treatment under my insurance policy, and understand that only
secondary coverage will be provided by The University of Houston-Victoria
3vs. 3 Soccer League.
PARENT/GUARDIAN SIGNATURE
PRINTED PARENT NAME/ CONTACT/ PHONE
Mailing Address:
_________________________________________________________
OTHER EMERGENCY CONTACT NAME & PHONE
_________________________________________________________
Fax, mail, or scan and email a copy of your insurance card.
Your copied insurance card can be brought the day of the
registration; however you will save yourself time if you send
it in advance.
Cell Phone: ____________________________________________
REGISTRATION DEADLINE IS APRIL 5 , 2013
In addition, I verify that my son/daughter is covered with a family health
insurance policy.
Player’s Name: _________________________________________
Home Phone: _________________________________________
REGISTRATION FEE IS $60 PER TEAM
OR
$20 AS A SINGLE PLAYER
I, the undersigned parent/legal guardian of :
GAMES ARE PLAYED APRIL 9TH-MAY 9TH ON TUESDAY
AND THURSDAY EVENINGS. EACH TEAM WILL PLAY A
TOTAL OF 5 GAMES AT THE UHV GAME FIELD. (NO
RESCHEDULE DUE TO WEATHER CONDITIONS)
REGISTRATION DEADLINE IS APRIL 5TH, 2013
3 vs. 3 SOCCER LEAGUE
THE UNIVERSITY OF HOUSTON-VICTORIA
MEDICAL & LEGAL RELEASE
Email:__________________________________________________
Checks:
The University of Houston-Victoria Soccer Camp
Mail to:
Adrian Rigby-UHV Soccer Camp
3007 N. Ben Wilson St.
Victoria, TX 77901
361-580-5524
361-485-4418
Current Team: ________________________________________
Current Coach’s Email: ________________________________
Age: __________
Boy: __________
Girl: __________
(REGISTRATION MUST INCLUDE A PASSPORT SIZED PHOTO)
___
FAX:
Office:
For further details, please email
[email protected]