Tryout Form

Please fill out form

Player's Information

Age Group: *

Are you also trying up an age group?: *

First Name: *

Last Name: *

Address: *

City: *

State: *

Birthday: *

Club/Team Played last season: *

Parent Information

First Name: *

Last Name: *

Phone/Cell Phone: *

Email Address: *

Requesting Financial Aid Assistance: *

Emergency Information

Emergency Contact: *

Emergency Phone: *

Health Insurance:

Policy Number:

Parent/Guardian Waiver

I, the parent/guardian of the above named player, a minor, agree that I and the player will abide by the rules and regulations of the US Youth Soccer, its affiliated organizations and its sponsors (US Youth Soccer Parties). I , for myself and the players and our respective heirs, administrators and successors, intending to be legally bound, herby release and indemnify the US Youth Soccer Parties, the owners and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player’s participation in the Programs including, without limitation, player’s transportation to/from any Program, which transportation is hereby authorized.

Select Waiver: *

I Agree

I Disagree

Consent for Medical Treatment

As the parent/guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent.

Select Consent: *

I Agree

I Disagree