CSA Tryouts

08:00 a.m.

Please complete or check input field

Parent or Legal Guardian First Name:

Parent or Legal Guardian Last Name:

Parent or Legal Guardian Email :

Player First Name :

Player Last Name:

Gender:

Age:

Phone:

Additional Email:

Player Date of Birth:

Hometown You Currently Live In:

Organization:

How did you hear about us?:

Uniform Size (Unisex sizing listed - please keep this is mind when selecting your size):

Race/Ethnicity (select all that apply):

Hispanic/Latino

Black/African American

Caucasian

Asian/Pacific Islander

Native American

Wish not to answer

What position do you typically play on field? (1st Preference):

What position do you typically play on field? (2nd Preference):

What position do you typically play on field? (3rd Preference):

Which academy/club team are you currently playing for?:

Please list your soccer experience, including any teams you have played for:

GPA:

Emergency Contact First Name:

Emergency Contact Last Name:

Emergency Contact Relationship:

Emergency Contact Phone number:

Waiver not active for this program

Signee Information (Must be an adult 18 years or older)

Full Name of Parent or Legal Guardian:

Signature:

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I agree to the Terms & Conditions :

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