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TRYOUT WAIVER\REGISTRATION FORM
 
 
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*Name: *Birth Date:
*Address: *City:
*Zip Code: *Home Phone #:
*Position: *Secondary Position:
*Prior Club: *Age Group:
*Gender:
*Div:
*Medical Conditions:   *Comments:
   
 
1- Name:
Mobile Phone:
Work Phone:
Email:
2- Name:
Mobile Phone:
Work Phone:
Email:

As the parent/legal guardian of the above-named player, or player age 18 or over by clicking submit 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 the life, limb or well-being of my dependent. I agree to hold harmless UC Premier and it agents and employees and hereby release them from any liability on account of injuries sustained by the player while participating in any activities. I give consent for the above player to be photographed, videotaped or filmed while participating in any soccer activities and the resulting photos / film to be used by UC Premier and its agents and employees for educational and promotional purposes. I have read and understand the above. I also acknowledge that players will be notified of team selection via the team manager or head coach after the tryouts and accept that the decision of UC Premier will be final.

NOTE: You will receive an email confirmation, please print/sign and bring with you to the location indicated by the UC Premier Representative who contacts you.

 

 
 

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