2008 EDUCC Online Pre-Registration

Age Matrix
U9 8/1/99 - 7/31/00
U10 8/1/98 - 7/31/99
U11 8/1/97 - 7/31/98
U12 8/1/96 - 7/31/97
U13 8/1/95 - 7/31/96
U14 8/1/94 - 7/31/95
U15 8/1/93 - 7/31/94
U16 8/1/92 - 7/31/93
U17 8/1/91 - 7/31/92
U18 8/1/90 - 7/31/91
U19 8/1/89 - 7/31/90
 

 

 
Player Information
Group: Boys  Girls
Age:     U9 U10 U11 U12 U13 U14 U15 U16 U17 U18/19
 
First Name:

Last Name:  

Address:
City: State:   Zip:
Phone: (Format: 916-555-1212)
Birth Date ,
Field Position: Forward    Midfield    Defense    Goal Keeper
Club/Team Played on Last Season:
 
Parent Information
First Name:

Last Name:  

Email:
Re-enter Email
for verification:
Phone:

Cell Phone:  

 
Address:
  Mark here if address is the same as player's information
   Street:
   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 the USYSA, its affiliated organization and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the USYSA accepting the registrant for its soccer program and activities (“The program”), I hereby release, discharge and otherwise indemnify the USYSA, 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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