Persepolis United Football Club

Youth Camp

Camp Registration Fee — $110/camper (Details & Waiver Below)

Price: $110.00

November 27-28 | 9AM-3PM Daily | Ages 6-12 | CYL Field at Wilson Farm Park 500 Lee Road, Wayne, PA

Parent/Guardian Name

First

Last

Parent/Guardian Email

Child Child Waiver

Parent/Guardian Phone #

Home Address

City

State

Zip Code

Child Name

First

Last

Child Age

Gender of Child

Child Position

Emergency Contact Name

First

Last

Emergency Contact Phone #

Parent/Guardian Comment

Please note anything else you would like the Camp Director to be aware of for your child.

How did you hear about us?

Waiver

By checking this box I understand that: Persepolis United FC Youth Soccer Camp Participant Information & Disclosures Organization The Persepolis United FC Youth Soccer Camp is independently organized and operated by Persepolis United FC. This program is not affiliated with, sponsored by, or endorsed by Tredyffrin Township or Wilson Farm Park except for the use of the permitted athletic field. Supervision Participants will be supervised by qualified coaches and staff throughout scheduled camp hours. Parents or guardians are responsible for ensuring children are dropped off and picked up on time. Persepolis United FC is not responsible for participants before check-in or after the designated pickup time. Medical Disclosure Parents/guardians are responsible for informing camp staff of allergies, medical conditions, medications, physical limitations, recent injuries, and emergency medical information. Children requiring medication must have all necessary medications with them and parents must provide written instructions if assistance is required. Emergency Medical Authorization In the event of an emergency, if a parent or emergency contact cannot be reached, parents authorize camp staff to obtain reasonable emergency medical treatment for their child. Parents remain financially responsible for any medical expenses incurred. Assumption of Risk Participation in soccer involves inherent risks including falls, collisions, contact with other participants, sprains, fractures, heat-related illness, and other injuries associated with athletic activity. By registering, parents acknowledge these risks and voluntarily permit their child to participate. Liability Release To the fullest extent permitted by Pennsylvania law, the parent or legal guardian releases and holds harmless Persepolis United FC, its camp directors, coaches, volunteers, and staff from claims arising from ordinary risks associated with participation in camp activities. Nothing in this release waives rights that cannot legally be waived under applicable law. Weather Policy Camp activities may be delayed, modified, relocated, or canceled due to lightning, heavy rain, dangerous field conditions, excessive heat, air quality concerns, or other unsafe weather conditions. Persepolis United FC reserves the right to adjust the schedule in the interest of participant safety. Hydration & Equipment Participants should bring soccer cleats or athletic shoes, shin guards, a soccer ball if requested, a labeled water bottle, weather-appropriate clothing, and sunscreen applied before arrival. Behavior Policy Participants are expected to respect coaches, teammates, officials, township facilities, follow camp instructions, and demonstrate good sportsmanship. Unsafe, disruptive, or inappropriate behavior may result in removal from camp without refund. Photo & Video Release Unless a parent specifically declines permission, photographs or videos taken during camp may be used by Persepolis United FC for social media, its website, promotional materials, and future camp advertising. Children’s names will not be published without additional permission. Township Facility Use Participants agree to help maintain Wilson Farm Park by properly disposing of trash, respecting facilities, remaining within permitted areas, and following all Tredyffrin Township park rules and regulations. Insurance Persepolis United FC recommends that all participants have personal health insurance. The camp does not provide individual accident or medical insurance coverage. Refund Policy Refund requests received before camp begins may be considered at the discretion of Persepolis United FC. Once camp has started, refunds generally will not be issued except under extraordinary circumstances. Parent Agreement By registering my child, I certify that my child is physically able to participate, the information provided is accurate, I understand the risks associated with participation, I agree to the camp policies and disclosures, I authorize emergency medical treatment if necessary, and I agree to the liability release and assumption of risk.

Camp Registration Fee ($110/camper)

Reach out to persepolis.unitedsa@gmail.com for any questions/concerns