Registration Form

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Registration Form
For Classic Players U11-U14 only.

NOTE: Prior to submitting this Registration Form and after filling in all required fields, please print out screen by clicking print button and bring printout to Tryout on May 4th.

Team Tryout Day Brochure is available here.

In addition, if you are electing to pay via Credit Card below, please be sure to proceed to the Online Payment page afterward and select and pay for the appropriate team. Your child is not completely registered until payment is received.

Name *
E-mail Address *
Player First Name *
Middle Initial
Player Last Name *
Gender *	Female Male
Desired Team *
Years Played *
Address *
City *
State *
Zip Code *
Home Phone *
Date of Birth (mm/dd/yyyy) *
Emergency Contact *
Emergency Contact Phone *
Guardian Name *
Guardian Relationship *
Guardian Phone *
Guardian Email
Guardian 2 Name
Guardian 2 Relationship
Guardian 2 Phone
Guardian 2 Email
Doctor *
Doctor Phone *
Medical Conditions/Allergies
Payment Option ($315 for U11, $345 for others) *	Credit Card (please proceed to Online Payment and pay after submission) Will bring check to Team Placement Day
Photo Release *	IN SHORT: I permit taking photos of player for use by NSC and OYSA. I further agree to sign full Photo Release on Team Tryout Day, May 4th, prior to start of event.
Acceptance of Financial Responsibility *	IN SHORT: I, the parent/guardian, hereby accept financial responsibility for the registrant. I agree to sign full Financial Responsibility Statement on Team Tryout Day, May 4th, prior to start of event.
Medical Release *	IN SHORT: I, the parent/guardian release NSC Soccer Program from all liabilities. I agree to sign full release waiver on Team Tryout Day, May 4th, prior to start of event.

* Fields marked with an asterisk are required fields

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Please print this screen prior to submission and after filling out all required fields. Then bring print-out to Team Placement Day on May 4th at George Fox University Soccer Field.

In addition, if you are elected to pay via Credit Card above, please be sure to proceed to the Online Payment page afterward and select and pay for the appropriate team. Your child is not completely registered until payment is received.