Player Information
Player Name: First Last Birthdate/Gender: (mm/dd/year) Boy   Girl
Street Address: City, State, Zip: ,
Previous Team: Previous Coach:
Yrs of Exp Travel: Yrs of Exp Rec:
Indicated Tryout Session You Will Attend: 1st 2nd BOTH - MTFC strongly recommends that players attend both days for better placement
T-Shirt Size:
Parent/Guardian Information
Parent/Guardian 1: Parent/Guardian 2:
Home Phone: - - Home Phone: - -
Mobile Phone: - - Mobile Phone: - -
Email: Email:
Re-enter Email: Re-enter Email:
Permission & Waiver:
I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the MTFC and that the registrant will respect the facility, other players, coaching and administrative staff of the MTFC while participating in its soccer programs. Recognizing the possibility of physical injury associated with soccer, and in consideration for the MTFC accepting the registrant for its soccer program, I hereby release, discharge, and/or otherwise indemnify the MTFC, its employees and associated personnel, including the owner of the fields and facilities used for the programs against any claim by or on behalf of the registrant as a result of the registrant’s participation in the programs and/or being transported to or from the same. My son/daughter has received a physical examination by a physician in the last year and has been found physically capable of participating in the programs.
Parent/Gaurdian Name (Name of Person Submitting this Form):
I agree to Electronic Signature/Waiver as indicated above.
As the parent/guardian of the player listed above, I hereby give my 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 the life, limb, or well being of my dependent. The coaching staff may provide initial medical assistance.
I agree to Electronic Signature/Consent for Emergency Medical Care.
Health Insurance Carrier/Policy #:
Player Known Allergies and/or Other Pertinent Medical Information:

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