Donation Form

Last day for registration is July 10th!

Please contact Francisco Lona with any questions at [email protected]

* INSTRUCTIONS *

1) Parent/Guardian please fill out and approve the
Parent Release & Consent Waiver, along with Sign-up Information.

2) Visit the AAU website at https://play.aausports.org/ to sign up for a youth membership. This provides additional participation insurance for $14.00 annually. (1. Click "Get A Membership" 2. Click "Youth Athlete Membership" 3. Select your sport). Please note your membership number to include with your registration.

3) Include your Payment details and Submit the entire page.

This form allows for pay by check, debit card, or a credit card.

AGREEMENT & INFORMATION MUST BE FILLED OUT ACCURATELY AND COMPLETELY

Participant Information

To be filled out by Parent or Legal Guardian.
Please submit 1 form per participant. Thank you.

Athlete’s First Name

Athlete’s Last Name

Athlete's Birthday

Age in Fall 2023

Shirt

Amount

Club AAU Membership ID Number (REQUIRED-this provides additional participant insurance for $14.00-$16.00 annually). Visit the AAU website at https://aausports.org/Join-AAU to sign up for a youth membership.

HEALTH & HEALTH INSURANCE
If no conditions exist enter NONE. Please list and describe all physical or emotional limitation(s) your child may have, including but not limited to: Allergies, Vision, Asthma, Heart Murmur, High Blood Pressure, etc.

I confirm that the participant is covered by Health Insurance and that the health information provided is accurate.

Health Insurance Carrier

Insurance Policy Number

By checking this box you confirm that you have read and agree to all terms in the above SDUHSD/TPHSF Parent Release and Waiver.

I agree to the TPHSF Falcon Safety Protocol terms outlining CDC guidelines.

By clicking this box you confirm that you have read and agree to all terms in the above HOLD HARMLESS, RELEASE OF LIABILITY AGREEMENT RELATED TO COVID-19 FOR EXTRACURRICULAR ACTIVITIES AND THE PARENT RELEASE AND CONSENT WAIVER.

I confirm that all is accurate and I agree to the SDUHSD/TPHSF HOLD HARMLESS, RELEASE OF LIABILITY AGREEMENT RELATED TO COVID-19 FOR EXTRA CURRICULAR ACTIVITIES AND THE PARENT RELEASE AND CONSENT WAIVER.

By checking this box you confirm that all the information provided in the above PARTICIPANT HEALTH INFORMATION & PARENT RELEASE & WAIVER is accurate to the fullest extent.

I confirm that all the information provided in the above PARTICIPANT HEALTH INFORMATION & PARENT RELEASE & WAIVER is accurate to the fullest extent.

By checking this box you confirm the use of electronic communication as your form of consent.

By checking here, you agree to the use of your electronic consent in lieu of an original signature on paper. You have the right to request to sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged and no special hardware or software is required to view it. Make sure that we have your current email address. I agree via electronic consent to the terms of the PARTICIPANT HEALTH INFORMATION & PARENT RELEASE & WAIVER.

Parent/Guardian Information

First Name

Last Name

Company Name

Address

Address 2

City

State/Province

Zip/Postal Code

Country

Cell/Emergncy Phone

Home Phone

Work Phone

Help Us Cover Costs - Tax Deductible Processing Fees

Simply leave "Yes!" checked below to ensure that 100% of your purchase is available for our mission.

Yes! I want to add processing fees so the full amount of $0.00 will go to your team/booster and I will donate $0.00.No. I will pay $0.00 and TP Boys Soccer will cover the processing costs.

Payment Information

Payment Options

Choose 'Bank Account' to Pay with a Check: Then simply click on the ? Help icon to see how to enter the routing and bank account numbers directly from one of your checks.

Credit Card Information

Card Holder Name

Card Account Number

Expiration Date

Security Code

Billing Address

Same As Above

Address

City

State/Province

Zip/Postal Code

Country

Privacy Policy: We take precautions to protect your information. We collect credit card or bank account information, names, addresses, and other data related to your transaction when you make a payment through the TPHS Foundation web site. We use this information to process your payment.

Terms/Conditions: By submitting your payment, you authorize us to charge your account for the amount specified in the Transaction Amount field. Account information for Recurring Pledges/Monthly Giving is encrypted and stored securely via SafeSave™ for automatic processing of your future payments. Notify us at anytime if you wish to discontinue your pledge.