Juventus STL SPRING ID SESSIONS REGISTRATION 2022

Welcome to Juventus Academy Saint Louis!

We would like to take this opportunity to welcome everyone to the Juventus global family! As we continue to expand the Juventus brand into the Midwest, we are excited to know you are interested in learning more about our academy.

Check in: opens 30 minutes before each session; ALL players are required to check in for contact tracing purposes
Walk-ins are welcome; pre-registration is preferred
OLYMPIA (indoor turf): 49 Lawrence St St Charles, MO 63301
PLAYERS: wear flat shoes for indoor training. Bring a soccer ball and water.

PLEASE SEE THE FLYER ABOVE FOR DATES/LOCATIONS/TIMES FOR EACH AGE GROUP

Please do not hesitate to reach out if you have any questions.

Thank you,

Niko Karidis | Club Director
Phone: (315) 516-4165
E-Mail: admin@juventusacademystl.com

PLAYER INFORMATION

First Name *

Last Name *

Gender *

Male

Female

Birth Year? *

Date of Birth (mm/dd/yyyy) * +

Current Team *

Playing Experience *

Player's School

Grade 2021-2022 School Year:

HOW DID YOU HEAR ABOUT US?

CONTACT INFORMATION

Parent's Name *

Relationship *

Cell Phone *

Parent's E-Mail Address *

2nd Contact Name *

Relationship *

Cell Phone *

2nd Contact's E-Mail Address *

LIABILITY WAIVER & RELEASE AGREEMENT

I the undersigned (if applicant/participant is 18 years of age or older) or parent/guardian of the above listed minor applicant/participant acknowledge that I have been advised of the risks involved in my son’s/daughter’s participation in Juventus Academy - Saint Louis and have been made aware that his/her participation may result in injury or harm to my son/daughter and I assume responsibility for any and all such risk to my son/daughter. In the event that my son/daughter may sustain an injury as a result of their participation, I hereby agree to hold harmless Juventus Academy - Saint Louis, Juventus Football Club, Karidis Group International, LLC, SLYSA Complex, Olympia Athletic Centre, LLC, any of it’s directors, officers, coaches, athletic trainers, supervisors, and any other employees or agents there of including those who transport them to/ from tryouts, practices, and games, for any and all such injuries. I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide my son/daughter with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I hereby authorize emergency transportation of my son/daughter to a medical treatment facility should an individual listed previously deem warranted. I affirmatively certify that to the best of my knowledge, my son/daughter is in good mental and physical health and capable of participating in this activity. I have read and fully understand the contents of this “hold harmless” agreement and execute same voluntary. If requested by Juventus Academy - Saint Louis staff, I agree to modify his/her activities as directed. I further give my permission for the free use of the participants name and image in broadcast, telecast, or any other media account of any and all event/activities and for the promotional purposes of Juventus Academy - Saint Louis, Juventus Football Club, Karidis Group International, LLC, SLYSA Complex, and Olympia Athletic Centre, LLC.

Liability Waiver & Release Agreement *

I understand and agree to the Liability Waiver & Release Agreement for the ID Sessions for the Spring 2022 season for Juventus Academy - Saint Louis.

Electronic Signature (please type first & last name) *

Date (mm/dd/yyyy) * +

Signature *

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