2023 7-12th Grade U17 and U19 East Range Soccer

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May-June Soccer

Email *

Player Last Name *

Player First Name *

Birthdate *

YYYY

Parents Name *

Parent Name #2

Address *

Player Cell Phone number *

Emergency contact number *

Parent(s) Home Phone Number(s) *

Parent(s) Cell Phone Number(s) *

Comments

Check box to acknowledge each statement. *

Players need to be less than 19 years of age and should be enrolled in 7-12th grade by Sept 2023.

Players will be required to follow all direction provided by coaching staff, if players cannot comply with direction they will be asked to leave

By completing this form, guardians and players are accepting any risk of contracting covid -19 and any consequence from covid-19.

I acknowledge reading and agreeing with page one of the liability agreement. Signed copy required at first practice.

I acknowledge reading and agreeing with page two of the liability agreement. Signed copy required at first practice.

Other:

Required

By completing this form, my child and I assume all responsibility *

Agree

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