2018-2019 UPRISE Field Hockey Club September Try Out Registration Form
Please complete the form below to register your athlete for UPRISE Field Hockey Club 2018-2019 tryouts. Tryouts will take place on Sunday, September 30 from 5:30-6:30 at Eastern Regional High School.

A $50 try out fee must be provided the day of tryouts. Upon arrival, please check in at the concession stand and provide payment. All payments are non-refundable and ONLY cash will be accepted

If you have ANY questions, please contact Danyle Heilig at uprisefhc@gmail.com

Player's Last Name *
Your answer
Player's First Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
USFHA Membership Number (you must be a member of the United States Field Hockey Association to play for a club program) *
Your answer
Position *
Emergency Contact and Phone Number *
Your answer
Birthdate *
MM
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DD
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YYYY
Age Group *
UPRISE Field Hockey Club LLC. Parent Consent and Waiver of Claims
In consideration of the application being accepted, I, intend to be legally bound, do hereby, for myself, my heirs, executors, and administrators, waive, release, and forever discharge any and all rights and claims for damages which I may have or which may hereafter acquire to me against UPRISE FH Club and Eastern HS and assigns, for any or all damages which may be sustained or suffered by me in connection with my association with or participation in, and/or arising out of my traveling to or returning from said tryout to participated in at Eastern HS. The tryout director has permission to seek medical attention for our child and I grant permission for a physician or other designated agent to provide medical treatment in the event of injury or sickness.
Parent/Guardian Electronic Signature for Consent *
Your answer
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