Step 1: Complete registration form. (Please fill in all of the boxes.)

Step 2: Hit "Submit Registration" button at bottom of form.

Step 3: Send check payable to: GRIFFIN SOCCER P.O. BOX 2047, CUPERTINO, CA 95015
"Old World Football, New World Soccer"TM
Program Information
Summer '10
Winter '11
Spring '11
June 21-25
January 9th - March 6th
Spring Break (March)
July 26-30
(Sunday afternoons)
August 2-6
@ Sunnyvale Soccer Complex
1095 Dunford Way, Sunnyvale
@ De Anza College (main gym)
Cupertino
@ Sunnyvale Soccer Complex
1095 Dunford Way, Sunnyvale
Half-Day 9:00am - Noon
$150 per player
($135 per player until Nov 30th, 2010)
Half-Day 9:00am - Noon
Mini-Camp 9:00am-10:30am
Mini-Camp 9:00am-10:30am
Half Day 4:00-7:00pm (7/26-30)
Program Discount (max. 1 per player)
Sibling -$15
Team (6+ players) -$15
Multi-session (2+ camps) -$15
Player Information
Last Name
First Name
Gender
Date of Birth
Age
Grade
Address
City, ST & Zip
FREE T-Shirt Size
Playing Information
Age Group
Level of Play
Club / Team
Parent / Guardian Information
Parent Name
Parent E-mail
Parent Phone
Emergency Contact Information
Emergency Contact
Emergency Phone
Insurance Company
Policy Number
Allergies
Other Information
Please include team or
teammate preference
or other pertinent info.
Program Recognition
How did you hear about our programs?
Participation Agreement / Waiver of Liability
I certify that my child is in excellent physical health, and may participate in strenuous and hazardous physical activities, including
the soccer and futsal to be played under the direction of Griffin Soccer (GS).  I certify that there are no physical limits to my child’s
participation.  I understand that accidents and injuries can arise from participation; knowing the risks, nevertheless, I hereby
agree to assume those risks on behalf of the above named Minor and to release and to hold harmless all of the representatives
of the GS.  Permission is granted for my child to receive emergency medical treatment if needed. I will be personally responsible
for any damages sustained by my child and any invited family participants to any GS equipment and/or any indoor or outdoor
facilities rented by GS.

In consideration of participation in the program offered above, I, the undersigned, as the parent/guardian of the Minor named
above, agree to indemnify and hold GS and its rented facilities harmless and hereby waive, release and discharge any and all
claims for damage, for death, personal injury, bodily injury or property damage which I and/or the Minor may have or which
hereinafter may accrue to me and/or the Minor against GS and may rise out of negligence or carelessness on the part of GS.  For
players on soccer teams, my child has his/her coach’s permission to participate in the GS soccer and futsal program. I agree to
allow use of photography and videography of my child for publicity.

It is understood and agreed that this waiver, release and assumption of risks has been freely entered into and is to be binding on
my heirs and assigns.  I represent that I am a parent/guardian of the Minor named above and I agree that the grant and release
contained therein binds me and the Minor to all its terms.
Participation Agreement
No information will be shared with any other parties.
* Please click once per registration - if successful you will see a copy of your information *
If you do not see a copy of your information, please call our office
(408) 446.0618
as your registration may not have been transmitted

Send check payable to:

GRIFFIN SOCCER
P.O. BOX 2047, CUPERTINO, CA 95015

Get in the action...Griffin Soccer & Phoenix Futsal
Online Registration
GRIFFIN SOCCER, PO Box 2047, Cupertino, CA 95015     (408) 446.0618
To register multiple players or multiple sessions:
Fill out the information for the first player to be registered, hit "Submit Registration" button at end of form,
then backspace in your browse and change any relevant information for the next player(s).