AYSO select team tryout registration form
Event Timing: November 30th- December 3rd, 2021
Event Address: Palo Alto, CA
Contact us at select@AYSO2.org
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Player First Name
Player Last Name
Player Date of Birth
Which tryout/groups are you attending?
(U19B) Boys 2003-2005 Tuesday, 7:00-8:30PM Mayfield SW
(U19B)Boys 2003-2005 Friday, 5:30-7:00PM Mayfield NW
(U19G)Girls 2003-2005 Tuesday, 5:30-7:00PM Mayfield SW
(U19G) Girls 2003-2005 Friday, 5:30-7:00PM Mayfield NW
(U13B) Boys 2009-2010 Tuesday, 5:30-7:00PM El Camino North
(U13B) Boys 2009-2010 Thursday, 5:30-7:00PM Mayfield NE
(U12G) Girls 2010-2011 Tuesday, 5:30-7:00PM Mayfield SW
(U12G) Girls 2010-2011 Thursday, 5:30-7:00PM Mayfield NE
(U10B) Boys 2012-2013, Tuesday, 5:30-7:00PM Mayfield SW
(U10B) Boys 2012-2013, Friday, 5:30-7:00PM Mayfield SW
(U10G) Girls 2012-2013, Tuesday, 5:30-7:00PM Mayfield SW
(U10) Girls 2012-2013, Thursday, 5:30-7:00PM Mayfield SW
Are you currently or recently an active AYSO player?
Which recent team/s did you play with?
Who is your current/recent coach?
Please read below:
A. Consent for Medical Treatment (Minor) *
As the parent or legal guardian of the above-named Player, 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. Please confirm consent below.
B. Liability Release Form *
I, the Player, or parent/guardian of the minor Player, acknowledge that soccer is an inherently dangerous sport in which the Player participates at his/her own risk. I, for myself and the Player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the (1) U.S. Youth Soccer and US Club Soccer, their affiliated organizations and its sponsors, (2) the AYSO Palo Alto soccer organization, its officers, directors, coaches, team managers, volunteers, agents, representatives and assigns, (3) the Palo Alto Unified School District and its subdivisions, the City of Palo Alto and all other organizations providing fields for play, including their agents, officers, directors, contractors, employees, representatives and assigns (collectively “Released Parties”), from and against all claims, liabilities, damages or causes of action arising out of or in connection with the Player’s participation in any and all AYSO Palo Alto soccer organization. I affirm that the Player is in good physical condition. I understand that the AYSO Palo Alto soccer organization does not carry medical insurance for Players participating in tryouts, practices, friendly scrimmages and other Palo Alto Soccer Club sponsored activities, and that I am responsible for the Player’s insurance coverage until the Player is officially registered as a Player with the California Youth Soccer Association or US Club Soccer. Please confirm release from liability below.
I have read and agree with the above waiver
A copy of your responses will be emailed to the address you provided.
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This form was created inside of AYSO Palo Alto.