1. <br /> Registration and Fees are due by: August 5 , 2011<br /> Fees (Includes shirt): Rs 400/Player<br /> Registration form<br />This is your registration form for the 2011 Lokgram football club! The team will play in a 11 on 11 soccer league. We will keep roster to a minimum size so all players will get a lot of action in this league. Games will be played saturday and sunday mornings . The goals of Lgfc are to emphasize good sportsmanship, quality instruction, and a relaxed atmosphere.This team is open to boys and girls of all age. Teams will generally play once a week for six Saturdays. Sunday afternoons will be used in case of rainouts. Players will be placed on rosters only when his or her application and fee have been received in the office. As usual volunteer coaches are needed to help make the team a success<br /> First Name__________________________ Last Name________________________<br /> M/F_______ Age_____ D/O/B__/___/_____ Class __________________________<br /> Address____________________________City_______________Zip____________<br /> Parents’ Names__________________________ School/College_______________________<br /> Phone Number (H)________________(M)________________________________<br /> Blood Group________________________ Injury (if any)________________<br />E-Mail______________________________ Parents interested in Coaching Yes__ No__<br />My signature acknowledges I am the parent or legal guardian of the above listed minor. I understand medical insurance is not provided with LGFC. I release the LGFC from any and all liability whatsoever resulting from participation in LGFC activities. I authorize those in attendance to act according to their best judgment in emergency situations requiring medical attention. I hereby waive and release the LGFC, it's staff, agents, sponsors, and/or coaches f rom any and all liability that may occur from accident, injury or illness sustained by my son/daughter during participation in these activities. I understand that no refunds will be applied within two weeks of the beginning date of a program. I understand behavior resulting in removal from a program does not constitute refund criteria. I understand that refunds, when applied, will have a $20.00 administrative fee accessed. I understand that if equipment is issued in conjunction with any program, failure to return said equipment within 2 weeks of the end of the program will result in legal action. I understand that photographs of all Lgfc activities and activities conducted by leased tenants will be taken and may be used for brochures, promotions and advertising without permission.<br />Parent/Guardian Signature ______________Date _______ Player signature ______________<br /> ________________________ <br /> Manager/Head coach signature<br />