Competitive Registration Form
Email address *
Player's Information
Player First Name (as it appears on birth certificate) *
Your answer
Player Last Name (as it appears on birth certificate) *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Player resides with: *
Mother's Contact Information
If not applicable type N/A
Mother's First Name *
Your answer
Mother's Last Name *
Your answer
Mother's Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Mother's Email *
Your answer
Mother's Phone Number *
Your answer
Father's Contact Information
If not applicable type N/A or if same as above type Same
Father's First Name *
Your answer
Father's Last Name *
Your answer
Father's Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Father's Email *
Your answer
Father's Phone Number *
Your answer
Emergency Contact Information
Person to notify in an emergency *
Your answer
Phone number of emergency contact *
Your answer
AYSA Code of Conduct
AYSA Code of Conduct * I, the parent/guardian of the above-named player, a minor, agree that we will abide by the Code of Conduct of Arizona Youth Soccer Association as described in https://usys-assets.ae-admin.com/assets/979/15/Code%20of%20conduct%202017-2018-LKC.pdf *
AYSA Concussion Policy
AYSA Concussion Policy * I, the parent/guardian of the above-named player, a minor, agree that we will follow the Concussion Policy of Arizona Youth Soccer Association as decribed in https://usys-assets.ae-admin.com/assets/979/15/AYSA%20Youth%20Soccer%20Head%20Injury%20Policy-Concussions%20Signs%20and%20Symptoms%20_%20Management%2007312015.pdf *
Agreement to Register
I, the above-named parent or guardian of the above-named child, am agreeing to register the above-named child for the Competitive program. *
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