Fall Soccer 2025 3 & 4 Year Olds Step 1 of 3 33% CompanyThis field is for validation purposes and should be left unchanged.3 & 4 Years Old In District Quantity Price: $15.00 Quantity 3 & 4 Years Old Out of District Quantity Price: $20.00 Quantity Total Register Participants(Required)First NameLast NameBirth DateGradeShirt SizeGenderAllergies/Restrictions Add RemovePlease enter as many participants as needed by using the “+” option on the right.Volunteer Name (Optional)Volunteer Coaches needed at all age levels. Parent/Guardian Name(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address City State / Province / Region ZIP / Postal Code Coupon Code Consent(Required) I agree to consent waiverWaiver and Release We/I, the undersigned participant or parent/guardians, understand that the Winnebago Park District provides no insurance coverage for medical costs and other damages arising out of any participation in the park district programs. Any insurance coverage will be furnished by the undersigned, and we are waiving and releasing all claims for injuries sustained during participation in the program(s). We release the instructors, supervisors, owners, independent contracts and park district members from any claims of injury or damage including any transportation associated with the program(s). A parental signature and mandatory attendance at informational meetings prior to the activity are required for participants under the age of 18. We do hereby give authorization and consent for our child/children listed above to participate in, to have photos published, and be transported as needed for the designated Winnebago park district programs. We give authorization to obtain medical treatment for my child in the event that the parent(s) and emergency contact cannot be reached. I understand and acknowledge that my enrollment and my participation in WPD programs is wholly voluntary and that there are physical risks and hazards connected with participation, including, but not limited to the risk of communicable disease such as COVID-19. I understand, acknowledge and agree that the Winnebago Park District is not responsible for and does not assume the cost of medical testing, care or treatment associated with my participation in WPD programs including but not limited to any medical testing, care and treatment of myself or anyone with whom I may have been in contact during or after my participation of a WPD program. Credit Card(Required) Cardholder Name Card Details Consent(Required) I agree to the privacy policy.