Contact | HEITS Academy

Player Information

First Name *

Last Name *

Date of Birth *

Gender

Jersey Size *

Preferred Position

Age Group / Program *

Team Selection *

Prior Experience

Parent / Guardian

First Name *

Last Name *

Email Address *

Phone Number *

Home Address

Same as parent/guardian

Emergency Contact Name *

Emergency Contact Phone *

Relationship to Player

Session Preferences

Preferred Training Days

How did you hear about HEITS?

Additional Comments or Questions

Liability Waiver & Consent

I, the undersigned parent/guardian, hereby enroll the above-named player in HEITS Soccer Academy programs and activities. I acknowledge that participation in soccer involves inherent risks of physical injury and agree to release HEITS Soccer Academy, its coaches, volunteers, and affiliates from any liability for injury or loss arising from participation, except in cases of gross negligence. I consent to emergency medical treatment if necessary and grant HEITS Soccer Academy permission to use photographs or videos of the player for promotional purposes. I confirm that all information provided is accurate and that the player is physically fit to participate. This waiver remains in effect for the duration of enrollment.

I have read and agree to the liability waiver and consent on behalf of the registered player. *

Player Registration

Player Information

Parent / Guardian

Session Preferences

Liability Waiver & Consent