Winter Clinic Registration
December 16th Session Only - $35

    Player Information

    Parent/Guardian Information

    By clicking the Submit button below, you agree to have read the following Liability Waiver & Medical Consent.
    You will then be directed to the online payment page to complete the registration process.

    We/ I, as the parent/legal guardian of the player named above, do hereby declare our intent to allow this child to practice, play, and participate in all programs and activities associated with the Pleasure Island Soccer Association, including any related activities and transportation. We/ I hereby release and hold harmless from any and all liability; Pleasure Island Soccer Association, its coaches, sponsors, associated board members and personnel, officials, or any others associated with this organization against any claim by or on behalf of the player’s participation in this program including any COVID-19 related sickness or bodily injury, and understand there is no medical insurance that applies. I/we agree that any photos taken of players for player cards, team photos or action photos I give consent to PISA to use for website and purposes for exhibit & promoting PISA programs. I understand there are no refunds of registration fees if season is cancelled due to circumstances out of the organization's control, whether natural or by government or other entity's orders that prevent us from holding activities.

    We/ I do hereby authorize Pleasure Island Soccer Association or any representatives including coaches, officials, or anyone associated with this organization, if after reasonable attempt has been made to reach the designated parent/guardian named above to consent, or if sound medical practice decrees that there is not time to make such an attempt, to consent to any x-ray, anesthetic, medical or surgical diagnosis or treatment or hospital care, to be rendered to the player under the general or special supervision and on the advise of any physician, dentist or surgeon duly licensed to practice, be indeed rendered to the Registrant. 

    By clicking the Submit button below, I agree to have read the Liability Waiver & Medical Consent above.
    I understand my child is not registered to participate until payment is made immediately upon submitting this player form.
    (you will be directed to payment page)