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PACIFIC SOCCER CLUB TRYOUT REGISTRATION
COMPETITIVE CLUB SOCCER – PROFESSIONAL TRAINING – PLAYER DEVELOPMENT

POSITIVE COACHING – GOOD SPORTSMANSHIP – EVERYONE PLAYS®

Pacific Soccer Club is a real club playing in one of the most competitive youth soccer programs in the country.

Every player must be registered with either AYSO or CalSouth in order to participate in a tryout.

Step 1: Select the tryout session that you want to attend.

Step 2: Preregister for the tryout by completing the form below.  If you preregister within 48 hours of the tryout you may need to register again at the field.  Click "Submit" once at the end of this form and wait 5 seconds, you will receive a pop up confirmation.

Step 3: Arrive 30 minutes (15 min if you preregistered) before the scheduled tryout.  Please have your player where a white t-shirt.

* You can also go to our Team Pages and contact the Coach directly.
http://pacificsc.org/wp/2016-2017-teams/

Thank you for your interest in Pacific Soccer Club.

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Player's First Name *
Player's Last Names *
Date of Birth *
mm/dd/yyyy
City *
Gender *
Player's Year of Birth *
Which year was your son or daughter born?
League *
What league did your son/daughter's team play in?
Registration *
Every player must be registered with either AYSO or CalSouth in order to participate in the tryout.  My son/daughter is currently registered with ...
Pacific Soccer Team Choice (Coach)
You are welcome to tryout for a specific team or any of our teams.  If you add a coach here that coach is the only one who will see your contact information.  If you leave it blank your information will be shared with coaches that have your gender and age division.
Tryout Date & Field *
Select the tryout(s) that you will be attending or enter the Date and City
Required
PARENT/GUARDIAN
Parent/Guardian First Name *
Parent/Guardian Last Name *
Email Address *
Phone Number *
7145551212 (Cell Phone is preferred)
IMPORTANT WAIVER
I, the parent/guardian of the above mentioned player, a minor, agree that I and the player will abide by the rules of AYSO, and its affiliated organizations and sponsors, specifically Pacific Soccer Club and AYSO Section 11.

Recognizing the possibility of physical injury associated with soccer and in consideration of Pacific Soccer Club accepting the player for team tryouts, I hereby release, discharge and /or otherwise indemnify the American Youth Soccer Organization, Pacific Soccer Club and their affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities, utilized for the tryouts, against any claim by or on behalf of the player as result of the player’s participation in the tryouts and/or being transported to or from same, which transportation I hereby authorize.
Authorization of Waiver *
Type your Full Legal Name
Date *
mm/dd/yyyy
CONSENT FOR MEDICAL TREATMENT (MINOR)
As the parent or legal guardian of the above named player, I hereby consent that in my absence, AYSO and/or Pacific Soccer Club may call for emergency medical services (911) and I
expressly consent to any treatment carried by any responding personnel or 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.
Authorization Consent for Medical Treatment *
Type your Full Legal Name
Date *
mm/dd/yyyy
EMERGENCY CONTACT:
Name
Emergency Contact Name
Phone Number
Emergency Contact Phone Number
Address
Emergency Contact Address, City
THANK YOU
Click "Submit" once at the end of this form and wait 5 seconds, you will receive a pop up confirmation.  You will NOT receive an email notification.


Posted:  January 2013
Updated for 2014: Jan 2014
Updated for 2015: Jan 2015
Updated for 2016
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