Fan Zone

Bluebirds Camps

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Soccer Player

First Name

Last Name

Date of Birth

Parent's Name

First Name

Last Name

Address

Street Address

City

Country

Phone

List any known medical conditions

*Campers will also recieve a camp shirt and two free tickets to an upcoming Club Atletico Saint Louis game*

PLEASE READ AND SIGN THE FOLLOWING WAIVER/MEDICAL RELEASE

I hereby give my permission for any and all medical attention necessary to be administered to my child in the event of an accident, injury, or illness. I authorize Club Atletico Saint Louis to request medical treatment as necessary to insure the well being of my child/ I also hereby waive and release Club Atletico Saint Louis, and staff for liability for injuries that may occur during training. I also understand that Club Atletico Saint Louis, retains the rights to use photos taken during the training sessions for public and/or advertising purposes.

Parent / Guardian Signature

Full Name

Sign

Date

Email ricardo@gobluebirds.com for any questions you may have.

Payment

Discount

Subtotal

Tax

Total USD

Bluebirds Soar across STL P1

Bluebirds Soar across STL P2

Terry Michler Vision

Hispanic Festival Inc.

Bluebirds Camps

PLEASE READ AND SIGN THE FOLLOWING WAIVER/MEDICAL RELEASE

Payment

The form has been submitted.

Soccer Mom Testimony

African Chamber of Commerce

Team Walkout

PLEASE READ AND SIGN THE FOLLOWING WAIVER/MEDICAL RELEASE

Payment

The form has been submitted.

Games