Soccer 2025

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthdate *

MM

DD

YYYY

Parent / Guardian *

First Name

Last Name

Primary Phone *

(###)

###

####

Secondary Phone

(###)

###

####

Emergency Contact *

First Name

Last Name

Emergency contact phone *

(###)

###

####

Release of liability *

Release of liability * I/We as the parent(s) or legal guardian of the child listed on this registration, understand the above named child will be participating in this Holbrook Recreation program. I/We release the RSU #63 District from any and all liability of whatever form which may arise as a result of any injury during the soccer program. I/We are giving the above said child permission to participate in the soccer program and take full responsibility for said child.

Yes

Photo permission

The league may occasionally post photos on websites or social media sites to help promote our activities. Please only check this box if you DO NOT want your child's photo to be used for promotional purposes.

I do not want my child's photo to be used