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Item Quantity Qty Total

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Camp Price 1 $0.00

Choose Extended Care (Player 1) – Extended Morning (8-9 AM, Mon-Fri) 1 $100.00

Choose Extended Care (Player 1) – Extended Afternoon (3-5 PM, Mon-Fri) 1 $200.00

Choose Extended Care (Player 1) – Extended Morning & Afternoon 1 $300.00

Choose Soccer Ball (Player 1) – Nike Pitch soccer balls (or similar): size 3 (ages 4-7) 1 $39.00

Choose Soccer Ball (Player 1) – Nike Pitch soccer balls (or similar): size 4 (ages 8-11) 1 $39.00

Choose Soccer Ball (Player 1) – Nike Pitch soccer balls (or similar): size 5 (ages 12-99) 1 $39.00

Choose Shin Guard (Player 1) – Nike J Shin Guard Medium (height: 63) 1 $25.00

Choose Shin Guard (Player 1) – Nike J Shin Guard Small (height: 40) 1 $25.00

Choose Extended Care (Player 2) – Extended Morning (8-9 AM, Mon-Fri) 1 $100.00

Choose Extended Care (Player 2) – Extended Afternoon (3-5 PM, Mon-Fri) 1 $200.00

Choose Extended Care (Player 2) – Extended Morning & Afternoon 1 $300.00

Choose Soccer Ball (Player 2) – Nike Pitch soccer balls (or similar): size 3 (ages 4-7) 1 $39.00

Choose Soccer Ball (Player 2) – Nike Pitch soccer balls (or similar): size 4 (ages 8-11) 1 $39.00

Choose Soccer Ball (Player 2) – Nike Pitch soccer balls (or similar): size 5 (ages 12-99) 1 $39.00

Choose Soccer Ball (Player 2) – Nike J Shin Guard Medium (height: 63) 1 $25.00

Choose Soccer Ball (Player 2) – Nike J Shin Guard Small (height: 40) 1 $25.00

Choose Extended Care (Player 3) – Extended Morning (8-9 AM, Mon-Fri) 1 $100.00

Choose Extended Care (Player 3) – Extended Afternoon (3-5 PM, Mon-Fri) 1 $200.00

Choose Extended Care (Player 3) – Extended Morning & Afternoon 1 $300.00

Choose Soccer Ball (Player 3) – Nike Pitch soccer balls (or similar): size 3 (ages 4-7) 1 $39.00

Choose Soccer Ball (Player 3) – Nike Pitch soccer balls (or similar): size 4 (ages 8-11) 1 $39.00

Choose Soccer Ball (Player 3) – Nike Pitch soccer balls (or similar): size 5 (ages 12-99) 1 $39.00

Choose Shin Guard (Player 3) – Nike J Shin Guard Medium (height: 63) 1 $25.00

Choose Shin Guard (Player 3) – Nike J Shin Guard Small (height: 40) 1 $25.00

Choose Extended Care (Player 4) – Extended Morning (8-9 AM, Mon-Fri) 1 $100.00

Choose Extended Care (Player 4) – Extended Afternoon (3-5 PM, Mon-Fri) 1 $200.00

Choose Extended Care (Player 4) – Extended Morning & Afternoon 1 $300.00

Choose Soccer Ball (Player 4) – Nike Pitch soccer balls (or similar): size 3 (ages 4-7) 1 $39.00

Choose Soccer Ball (Player 4) – Nike Pitch soccer balls (or similar): size 4 (ages 8-11) 1 $39.00

Choose Soccer Ball (Player 4) – Nike Pitch soccer balls (or similar): size 5 (ages 12-99) 1 $39.00

Choose Shin Guard (Player 4) – Nike J Shin Guard Medium (height: 63) 1 $25.00

Choose Shin Guard (Player 4) – Nike J Shin Guard Small (height: 40) 1 $25.00

Choose Extended Care (Player 5) – Extended Morning (8-9 AM, Mon-Fri) 1 $100.00

Choose Extended Care (Player 5) – Extended Afternoon (3-5 PM, Mon-Fri) 1 $200.00

Choose Extended Care (Player 5) – Extended Morning & Afternoon 1 $300.00

Choose Soccer Ball (Player 5) – Nike Pitch soccer balls (or similar): size 3 (ages 4-7) 1 $39.00

Choose Soccer Ball (Player 5) – Nike Pitch soccer balls (or similar): size 4 (ages 8-11) 1 $39.00

Choose Soccer Ball (Player 5) – Nike Pitch soccer balls (or similar): size 5 (ages 12-99) 1 $39.00

Choose Shin Guard (Player 5) – Nike J Shin Guard Medium (height: 63) 1 $25.00

Choose Shin Guard (Player 5) – Nike J Shin Guard Small (height: 40) 1 $25.00

Subtotal

Total $0.00

Camp Price

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Agreed Waivers

Required Waiver for World Cup Soccer Camps

Parental Consent

I grant my child(ren) permission to participate in the World Cup Soccer Camps/Classes (WCSC). I understand that soccer activities are of a strenuous nature that do pose some risk of injury. As parent/guardian, I waive all claims of liability against World Cup Soccer Camps, its directors, employees and the cities, schools and facilities of Atherton and Laurel School (LC & UC) and Las Lomitas School, Belmont and Cipriani ES, Burlingame, Campbell, Carlmont High School and Sequoia Union High School District, Concord, Cupertino and Far East Institute, Danville, Dublin, Foster City, Lafayette, Los Altos, St. Simon School and Los Altos School District, Town of Los Gatos and LGS, Mansfield and Apex Indoor Sports Center, Millbrae, Milpitas, Oceanside, Orinda and Orinda Intermediate School, Palo Alto, Redwood City, Reno and Swift Sportsdome (North and South), Rochester and Total Sports Experience, Rancho Cordova and Le Five Rancho Cordova LLC, San Carlos, San Francisco and City College of San Francisco, San Jose, Orion Montesorri School and Saint Frances Cabrini School, San Mateo, Santa Cruz, Bay View ES, DeLaveaga ES, and Westlake ES, Saratoga and St. Andrews School, Sunnyvale, Tustin, Union City and, West Sacramento and Le Five West Sacramento LLC. My child will participate in the camp using proper protective equipment and he/she does so with my permission at his/her own risk.

In case of emergency, I hereby consent to medical examination and/or treatment for my child(ren). WCSC reserves the right to use any photographs or video taken by WCSC during camps, clinics, personal training or any other sponsored events by WCSC without the expressed written permission of those included within the photographs/video. WCSC may use the photographs/video in publications or other media material produced, used or contracted by WCSC including but not limited to: brochures, invitations, books, newspapers, magazines, television, websites, social media etc. Any person desiring not to have their photo taken or distributed must contact us at camps@worldcupsoccercamps.com in writing of his/her intentions.

By registering for our camps/classes/practices you confirm compliance with each county’s health guidelines.

City of Palo Alto Waiver

I give permission to participate in the following programs, including any associated travel sponsored by the City of Palo Alto Community Services Department, for myself and/or child as named. In consideration for participation in the programs, I agree to the following: I understand that participating in the programs is a voluntary activity that I am choosing to participate in and is not required. I understand that there are inherent risks in participating in the programs which may be both foreseen and unforeseen and include illness, physical injury, and death.

I understand that there is a coronavirus pandemic in effect, that the City will provide the programs in compliance with state and local health guidelines. I understand that even when operating under such guidelines, there is still a risk of being infected by coronavirus. I understand that participants may be required to use safety gear consistent with such guidelines, including, without limitation, face coverings and hand sanitizer, and will be required to follow guidelines related to social distancing, possible exposure, quarantine, and other safety protocols. I understand that there are individuals who may be medically exempt from wearing a mask or face covering throughout the class. I agree that participants must be symptom free (no coughing or fever) in order to participate in the program.

Additionally, I agree to ASSUME ALL RISKS of participating in the programs. I agree to DISCHARGE AND RELEASE (agreeing to make no claim and not to sue) and HOLD HARMLESS the City of Palo Alto, its employees, its agents, its independent contractors, and volunteers working for the City, from any and all liability for injury suffered by me or my child arising from or connected with these programs. I understand and agree that this ASSUMPTION OF THE RISK, DISCHARGE AND RELEASE, AND HOLD HARMLESS includes any claims relating to the actions, omissions, or negligence of the City, its employees, agents, independent contractors, and volunteers.

If participant’s family member or someone in close contact with the participant (outside of this program) tests positive for COVID-19, or if participant tests positive for COVID-19, I give permission for the City to notify other people in contact with the participant (including other program participants, staff, and volunteers) that they may have been exposed to COVID-19. In doing so, the City shall not identify the participant or their family by name except as required by government mandates.

I acknowledge that I have carefully read this liability waiver and understand the information herein, and that I agree to each of the terms and acknowledgments in this liability waiver.

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