Select Soccer Tryout Registration

Prospector Select Tryout Registration

Player
First & Last Name*

Gender*

Email Address*

Position*

Street Address*

Goalie*

City*

Foot*

Phone*
(Format 916-555-1212)

Years Rec

Club Played Last
Year

Years Select

Birth Date*

Years Comp

Tryout Attending*

Select Age Matrix

* Required Fields

Emergency
Contact*

Emergency
Phone*

Physician
Name*

Physician
Phone*

WAIVER: I, the parent/legal guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of the
El Dorado Youth Soccer League (EDYSL), the California Youth Soccer Association (CYSA) and its affiliated organizations
and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the EDYSL
accepting the registrant for its soccer programs and activities (the Programs), I hereby release, discharge and/or
otherwise indemnify the EDYSL, all clubs affiliated with the EDYSL, the CYSA and its affiliated organizations and sponsors,
their employees and associated personnel, including the owners of fields and facilities utilized for the Programs against
any claim by or on behalf of the registrant as a result of the registrant's participation in the Programs and/or being
transported to or from the same.

Parent/Guardian (First & Last Name)*

I Agree to Waiver

________________________________________
Parent/Guardian Signature

Steps to complete the Select tryout registration process:

1) Please print the form first, have a parent sign it, and bring it to the registration table at the first tryout you attend.

2) After you have successfully printed the tryout registration form, then submit the form once.

Please PRINT the form.

Please SUBMIT once only.