Mail to:
USAYSO, 11600 Manchaca Rd #101
Austin, Texas 78748
Include a copy of the player's birth certificate
Player Registration Form
Please complete the information below :
Player's Information:
Name:
Address: Street,City, & Zip
Date of Birth:
Gender:
Parent /Guardian Name:
Home Phone:
Cell Phone:
Email:
Emergency Contact:
Relationship:
Home Phone:
Cell Phone:
Doctors Name:
Phone:
Insurance Company:
Policy Holder's Name:
Phone:
Policy Number:
Consent for Medical Treatment
As a parent or legal guardian of the registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependent.
Parental Support
USAYSO is a organization run mostly by volunteers. Each team, as well as the organization as a whole, requires adult participation. Please indicated below how you will contribute.
Seasons Played, Prior Team, &Prior Coach:
Comments:
New Players Uniforms Size:
Payment Method
Player Age Group
Consent for Play
WE HEREBY AGREE THAT USA YOUTH SOCCER AND ITS MEMBERS, COACHES OR OFFICERS SHALL NOT BE LIABLE FOR ANY INJURY OR LOSS WHICH MY CHILD MAY SUSTAIN WHILE PARTICIPATING IN ACTIVITIES OF ANY KIND WHETHER SPONSORED BY OR UNDER THE SUPERVISION OF USA YOUTH SOCCER AND WE AGREE TO INDEMNIFY AND TO HOLD HARMLESS USA YOUTH SOCCER, ITS MEMBERS, COACHES, OFFICERS OR DESIGNATES OF ANY KIND FROM ANY CLAIM WHATSOEVER.WE HERE BY AGREE TO PAY ALL FEE’S AND PENALTIES FOR THIS SEASON.
To pay with credit card click to submit form. On the submittion page click the submit credit card payment button. Thank you!
