Player Tryout Application

2009/10
Age Matrix
U9 8/1/00 - 7/31/02
U10 8/1/99 - 7/31/00
U11 8/1/98 - 7/31/99
U12 8/1/97 - 7/31/98
U13 8/1/96 - 7/31/97
U14 8/1/95 - 7/31/96
U15 8/1/94 - 7/31/95
U16 8/1/93 - 7/31/94
U17 8/1/92 - 7/31/93
U18 8/1/91 - 7/31/92
U19 8/1/90 - 7/31/91
U21 8/1/88 - 7/31/90
 

 

 
Player Information
Level: *(check all that apply)  Super Y  Class 1  Class 3 
Group:* Boys  Girls
Birth Date:* ,   (Month/Date/Year)
 
First Name:*

Last Name:*

Street Address:*
City:* State:   Zip:*
Phone:* () (925) 555-1234
Field Position:*
(check all that apply)		 Forward    Midfield    Defense    Goalkeeper
Last team played for:*
 
Parent Information
First Name:*

Last Name:*  

Email:*
Re-enter Email:*     
Phone:* ()

Cell Phone:  

()
 
Street Address:*
  Mark here if address is the same as player's information
   Address:
   City: State:   Zip:
      
Emergency Information
Emergency Contact:*
Emergency Phone:* ()
Doctor to Notify:
Doctor Phone: ()
    
Parent/Guardian Waiver *

I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of US Soccer, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for US Soccer accepting the registrant for its soccer program and activities (“The program”), I hereby release, discharge and otherwise indemnify US Soccer, its affiliated organizations and others, their employees and associated personnel, including the owners of the fields and facilities utilized for the program against any claims by or on behalf of the registrant as a result of the registrant’s participation in the program and/or being transported to or from the game, which transportation I hereby authorize.

I Agree         I Disagree
 


 

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