Player’s First Name: Last Name: Street Address: City: Zip Code: Birth Date: Gender: Male Female Grade: Pre-School 1st 2nd 3rd 4th 5th Parent/Guardian: Contact Phone: Contact E-mail: Which elementary schools do you live near? First Closest School: Please choose an option AJ Katzenmaier Greenbay Howard A Yeager Marjorie P Hart North Elementary South Elementary Second Closest School: Please choose an option AJ Katzenmaier Greenbay Howard A Yeager Marjorie P Hart North Elementary South Elementary What position(s) do you normally play? (check all that apply) Forward Midfield Defense Goalkeeper What position(s) do you want to play? (check all that apply) Forward Midfield Defense Goalkeeper Already Have a Uniform Jersey Size: Shorts Size: Youth Small Medium Youth Small Medium Youth Medium Large Youth Medium Large Youth Large Extra-Large Youth Large Extra-Large Small Small Permission to Play I, the parent or guardian of the minor registrant, agree that the registrant and I will abide by all the rules of the Northside Youth Soccer League (NYSL). In recognizing the possibility of physical injury associated with soccer and in consideration for the “League” accepting the registrant for its soccer programs and activities, I hereby release, discharge, and/or otherwise indemnify NYSL, their employees and associated personnel and volunteers, including the facilities used for practices and games, against any claim 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 NYSL sponsored activities, which transportation. By entering my name below, I hereby agree and authorize the above. In addition, by signing below, I also acknowledge that I have read the cancellation policy and agree to its terms. Parent/Guardian Name: Date:
