Girls Soccer Performance

Phone:770-823-9831 Emailinfo@furyperformanceacademy.com Contact Form

Poster announcing Fury Performance Girls Soccer; includes logos, large 'SOCCER PERFORMANCE' text, and soccer ball in a goal with a blue 'Ages 7-10' band and date details.

Fury’s Girls Soccer Performance will be held on Saturday, July 11th at our Woodstock location. This is the perfect opportunity for your athlete to develop the necessary skills to enhance their abilities, learn new techniques and become the best soccer player they can be. Your athlete can expect to be challenged and participate in competitions throughout the clinic.

PAYMENT *

Age Group *

Payment Information

At the completion of this form you will be automatically redirected to PayPal for payment. You may pay utilizing your PayPal account, a debit or credit card. If you are unable to provide a credit/debit card online, you are welcome to send a check to Fury Performance at 202 Rope Mill Road, Suite B., Woodstock, GA 30188. Please make checks payable to Fury Performance and write your athlete’s name and grade on the check. You may also pay cash in person at Fury Performance. If you have any questions please call or text us at: 770.823.9831

Athlete Information

CAMPER’S LAST NAME *

CAMPER’S FIRST NAME *

CAMPER’S DATE OF BIRTH *

Parent/ Guardian Information

PARENT’S LAST NAME *

PARENT’S FIRST NAME *

EMAIL ADDRESS *

PHONE NUMBER *

Emergency Contact Information

Please name any contact other than the parent listed above to contact in the event of an emergency

Name *

Phone Number *

Waiver and Release of Liability

I understand that, in sports performance and football camps, there is always a risk of permanent or partial injury and/or disability. I hereby waive and release Fury Performance, the owner, employees, sponsors, and all participants directing their programs from any liability for injuries the student might incur while participating in the programs, camps, clinics, and training sessions. I certify by my signature below, that I know of no mental or physical problems that might affect the athlete’s ability to safely participate in the programs offered by Fury Performance. I further agree to be solely responsible for any medical or related expenses that arise from the athlete’s participation and/ or attendance in the programs offered by Fury Performance. I hereby authorize the coaches and/or instructors and/or management of Fury Performance to act for me in my absence according to their judgment in any emergency requiring medical attention.

Any Additional Notes for our Staff

Captcha *

reCAPTCHA is required.