Lady Gunners: the Non-Club Soccer Experience! Clubs Soccer Results...or Your Money Back!

Full Name *

First Name Last Name

Gender

Male Female

Date of Birth *

Month Day Year

Age *

years

Height *

Player Shirt Size *

Program you're Interested in?

Little Gunners (Boys) Lady Gunners (Girls) Young Gunners (HS Boys)

What Team(s) do you Currently Play for?

List All if More than One.

What Position(s) do you Play?

List All in Priority Order

Do you train or your own? If so how often?

It's OK to Put No, if you Don't.

Please list physical activities you participate in outside of soccer:

It's ok to put 'None' if there aren't any.

Any Health Problems that can Affect your Training? *

Are you on any medications? (Inhaler for Example) *

If you have any injuries, please list them.

Please rate your Fitness Level. *

Which of these options Best Fits your Goal(s)? I want to Improve: *

Technical Skills Fitness Endurance Speed Tactical Awareness Confidence in Abilities

What would You like to Achieve if You were to be Chosen? *

In a Few Words, Explain

What Difference Would it Make in your Game to Achieve it? *

How you Picture Yourself as a Player Once Achieved

What is Holding Back from Achieving your Goals? *

Is it Motivation, Lack of Proper Training...

How often are you Willing to Train to Reach your Goals? *

Please Choose

Disclosure
"Participants should be aware of safety concerns Authorization can only be
granted by the Program Director."Board of Health Requirements" 430.190: General Program Requirements "This camp must comply with regulations of Massachusetts
Department of Public Health and be licensed by the local board of health."
Mass Young Gunners shall inform parents that they have the right to request copies of
background checks, health care, and discipline policies as well as procedures for filing grievances.

Clinic Waiver Agreement
Camp / Clinic Waiver We/I hereby request your acceptance of this application, we/I hereby agree to release, indemnify and hold harmless (Mass Young Gunners), its agents, employees, representatives or assigns, including directors, the coaching and training staff and camp employees, from all claims resulting from any injury sustained by my child while traveling and participating in the camp. We/I further hereby give permission to the coaches, training staff, or other medical professionals to provide medical care as deemed necessary to my child in case of injury or illness.

I AGREE TO THE ABOVE TERMS & CONDITIONS! *

Yes No

PLAYER PROFILE

Please complete Your Player Profile so we can
Properly Assess Whether this is the Right Fit.

BASIC INFORMATION

CURRENT PLAYING STATUS

MEDICAL / HEALTH INFORMATION

GOALS

Please Read The Following Terms and Conditions.