CDA

CDA Tryout Registration

Player Information


First Name:		Last Name:
Address:
City:		State: Zip:
Phone:		(Format Sample: 916-555-1212)
Gender	Boy
Birth Date		(Format Sample: 6/15/1998)
Field Position:	Forward Midfield Defense Goal Keeper
Club/Team Played on Last Season:

Parent Information


First Name:		Last Name:
Email Address:
Re-enter Email:	for input 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 US Club Soccer and US Soccer, its affiliated organization and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the US Club Soccer and US Soccer accepting the registrant for its soccer program and activities (“The program”), I hereby release, discharge and otherwise indemnify the US Club Soccer and US Soccer, their 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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