Registration Form

Player’s First Name: Last Name:

Street Address:

City: Zip Code:

Birth Date (dd/mm/yyyy): Gender:Female Male

Grade: Pre-School 2^nd 3^rd 4^th ^5th

Parent/Guardian:

Contact Phone:Contact Email:

Which elementary schools do you live near?

First Closest School:

Second Closest School:

What position(s) do you want to play? (check all that apply)

Forward	Midfield
Defense	Goalkeeper

Already Have a Uniform

Jersey Size:		Shorts Size:
Youth Small	Medium	Youth Small	Medium
Youth Medium	Large	Youth Medium	Large
Youth Large	Extra-Large	Youth Large	Extra-Large
Small		Small

Permission to Play

I, the parent or guardian of the minor registrant, agree that the registrant and I will abide by all the rules of the Northside Youth Soccer League (NYSL). In recognizing the possibility of physical injury associated with soccer and in consideration for the “League” accepting the registrant for its soccer programs and activities, I hereby release, discharge, and/or otherwise indemnify NYSL, their employees and associated personnel and volunteers, including the facilities used for practices and games, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the program and/or being transported to or from NYSL sponsored activities, which transportation.

By signing below, I hereby agree and authorize the above. In addition, By entering your name below, yOU also acknowledge that YOU have read the cancellation policy and agree to its terms.