Winter Road Show Registration How did you Learn about the camp?* Previous MI camper Previous 'Big Show' camper Email Web search My coach me about it Coach Name Promo Code Camper Registration* Full payment Down payment Camper Registration for AU GKs* Full payment Down payment ($100) AU GKs receive $85 off!Total $0.00 Camper Name* First Last Gender* Male Female Camper Birthdate Month Day Year T-shirt Size* Youth Large Adult Small Adult Medium Adult Large Adult XL School Grade* Please enter the number of the grade camper currently is in.Club/School Please list your club and/or school affiliationCamper city and state* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Best Number to reach you during the day*Email* Email will be our main method of communication with you about camp, so please use an email you check frequently.Waiver and Release of Liability* I agree In consideration of Clark Keeper Training (CKT) and John Clark furnishing training and/or equipment to enable my child to participate in the sport of soccer goalkeeping I agree as follows: I fully understand and acknowledge that soccer and soccer goalkeeping have: (a) inherent risks, dangers and hazards and such exists in my participation in goalkeeper training activities; (b) my participation in such activities and/or use of such equipment may result in injury or illness including but not limited to bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of Clark Keeper Training or Camp Shutout, the negligence of the participants, or the negligence of others. I hereby assume all risks and dangers and all responsibility for any losses and / or damages whether caused in whole or in part by the negligence or other conduct of anyone associated with Clark Keeper Training or Camp Shutout or by any other person. I, on behalf of myself, my personal representatives and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify Clark Keeper Training, and Stan Anderson and Camp Shutout from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my participation in the goalkeeper training program. I also agree to allow Clark Keeper Training to use photographs and/or video of me to promote the West Michigan Camp Shutout program. BY CHECKING THE BOX ABOVE, I SIGNIFY THAT I HAVE READ THIS WAIVER AND RELEASE AND BY CHECKING THE BOX I AGREE. IT IS MY INTENTION TO EXEMPT AND RELIEVE CLARK KEEPER TRAINING FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE.CAPTCHA