5 Star Soccer Camps - Programs 2024
WAIVER & RELEASE FORM
IMPORTANT - All fields are required, and must be completed BEFORE your youth player may participate in any camp activities.
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Locations *
First Name *
Last Name *
M / F *
Age *
Parent / Guardian *
First / Last Name of the primary contact.
Phone *
Best number for call or text to reach Parent / Guardian. 1-222-333-4444 format please.
Email *
Please enter the most often checked email.
Waiver *
In consideration of being enrolled the current program offering, I acknowledge and agree that injury may occur, and hereby give permission and certify that my son / daughter is in good health and able to participate in all camp activities. I understand the risks and assume all responsibility that comes from participation. I, and on behalf of my heirs, assigns, personal next of kin, release and hold harmless all coaches, staff and all others associated with 5 Star Soccer Camps!, Inc. including officers, officials, agents, and/or employees, sponsoring agencies, sponsors advertisers and if applicable, owners and lessors of premises used for the event of any and all liability for any injury, disability, death, or illness incurred by my child at the soccer training program and/or camp activity. This includes any loss or damage to person or property, whether arising from the negligence of the releases or otherwise. I have looked over the facility for this event and acknowledge it as appropriate for the program, understanding that 5 Star Soccer Camps!, Inc. is not warranting the condition of the facility, or field space. I give 5 Star Soccer Camps!, Inc. permission to use without compensation, myself or my child’s image, likeness, or quotes in connection with any promotional materials including but not limited to: brochures, advertising & social media or website publications. In case of emergency, I grant permission for my son / daughter to be given emergency treatment at a local hospital. I have read this waiver and release of liability and agree to its terms.
Required
Testimonials
“Coach Wiggins was instrumental in my early development as a youth soccer player.  His guidance helped me improve my soccer skills, along with the physical and mental aspects of the game.  The early stages of player development are crucial, and Coach Wiggins has proven to be effective in guiding players to long and successful soccer careers.”

Tim Regan – Former professional player and 6 year veteran of MLS.
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