Player Name__________________________________ Tryout # ___________

Age ______ DOB_______

Parents Name/s____________________________/______________________________

Please place an asterisk/s next to the contact number where we can reach you after tryouts/evaluations.

Once we offer you placement on a team we will ask you to confirm within 24 hours of our initial call or email.

We will leave a message if there is no answer. You will also be asked to immediately pay your club registration

to secure your spot.

Emergency Contact Number_______________________ Home Number__________________________

Cell Phone/s____________________________________/______________________________________

Parent Email_______________________________ Player Email ________________________________

Position/s Played_______________________________________________________________________

Previous Club Season Team ________________________Coach_________________________________

Previous Level of Play: Rec/Developmental____ Academy_____Classic____ Challenge_______

Desired Level of Play: Rec/Developmenatl____ Academy______Classic____Challenge _______

Desired Coach or Coaches ________________________________________________________________

If you do not get offered your desired level of play are you willing to accept other offers? Yes /  No

Are you involved with activities that may affect your attendance at midweek soccer practice?  Yes / No

If yes, explain what activity, nights and times it will affect your attendance__________________________

______________________________________________________________________________________

Are you involved with other activities that will affect your attendance at Saturday or Sunday soccer games? 

Yes / No                 If yes, explain____________________________________________________________

U17-18 players, do you wish to play in college and need our assistance with recruiting?  Yes / No

U13-14 Players, are you intending to tryout for Junior Varsity?  Yes / No 

All players, are you involved with other sports or activities that will affect your attendance? Yes / No If yes, please explain:____________________________________________________________________

Club Use: Time and date called_______________  By whom_____________________

Age & level Offered ___________________ Additional comments/notes on reverse