2018 SOCCERSMITH SUMMER SELECT TRYOUT REGISTRATION
Registration does not guarantee you a spot with the Summer Select program. Teams will be selected based on evaluations conducted by SoccerSmith Staff. NO PAYMENT is due at this time. If your son or daughter is selected for a team, the fee for the program will be assessed.
Select Age Group *
Last Name *
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First Name *
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Date of Birth *
MM/DD/YYYY
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Primary Email Address *
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Secondary Email Address
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Home Address *
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City *
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State *
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Zip Code *
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Please select positions played *
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Home Phone
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Cell Phone
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Emergency Contact Person and Relation *
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Emergency Contact Phone Number *
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Weekend Availability *
Please click all weekends you expect to be available for summer tournaments
Required
Waiver-Please read the following waiver carefully and electronically sign your name below.
Recognizing the possibility of physical injury associated with soccer and in consideration for SoccerSmith, LLC accepting the registrant for the Summer Select Program, I hereby release, discharge and/or otherwise indemnify SoccerSmith, LLC and NexLevel Arena and NexLevel Services and its affiliated organizations and sponsors, their employees and associated personnel, including the owner of fields and facilities utilized for the SoccerSmith Summer Select tryout against any claim by or on behalf of the registrant as a result of the registrant’s participation in the said tryout and/or being transported to or from the same, which transportation I hereby authorize. My son/daughter has received a physical examination by a physician and has been found physically capable of participating in the SoccerSmith Summer Select Tryout and Program. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment and agree to be responsible financially for the cost of each assistance and/or treatment. Please show your agreement by typing your name below. (Electronic Signature)
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