Tryout Registration Form 2019 (2012 to 2006)

Tryout Registration Form 2019 (2012 to 2006)

U9 to U14 Boys and Girls

Instructions

* Medical Treatment Authorization and Liability Waiver
I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge, and otherwise indemnify Azzurri SC, their sponsors, the USSF and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the soccer player named above as a result of that player’s participation in US Club Soccer programs and/or being transported to or from the same, which transportation I hereby authorize.
* Photo Release
I also hereby authorize Azzurri SC to publish photos of my child on the official Azzurri SC website and/or for any advertisements and newsletters. The photos will be used to aid potential participants to help obtain a visual depiction of the Azzurri SC experience. I stipulate that the photos not be identified in any way with the personal information other than first names. The photos will not be used for any other purpose than stated above. Not all photos will be used, only those deemed most advantageous for the purpose stated above.

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