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First Name Middle Name Insurance Address Date Of Birth Grade Shirt Size Returning Player Parents Name Address Phone E-mail Emergency Contact Emergency Contact Phone Pick Up School Upload Picture

I agree to the Agreement, Waiver and Release

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Please, fill all the form entries accurately. Make sure that your address includes City and ZIP code. Select shirt size from the list and select grade. If the player participated in our program before, make sure you select Returning player, otherwise select New player.
Please, fill your parents information, especially phone and e-mail as it would be our only way to communicate with you. In the Provider list, please pick your wireless provider so we can contact you via text messages.
Please, fill Insurance and emergency contact information. This information is used if the player gets injured as is essential to ensure your child's safety and well being
Select Pick Up option - if you pick up player by yourself, chose by Parent. If you wish your child to walk home, select Released. If your child attends afterschool program, and goes there right after practice, select Afterschool Program.
Finally select school and attach picture of your child.

Thank you for registering your child!!!

Provider

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CALIFORNIA SOCCER FOUNDATION