UPRISE Field Hockey Club U12 Try Out Registration 2021-22
Please complete the form below to register your athlete for UPRISE Field Hockey Club 2021-22 tryouts. Upon arrival, please report to the field hockey turf (McAleer Stadium) check-in at the concession stand.

***$25 for Current U12-U19 UPRISE Field Hockey Club Members, $50 Non-UPRISE Members***

All payments are non-refundable. Payments can be paid in Cash at Check-In or Venmo (@DHeilig) after completing this tryout form.

Dates and Times of Tryouts:
U 12 (born after 2009) - Tuesday, June 29 Check-In 4:45-5 pm, Tryouts 5:00-6:30 pm
Tryouts will be held at Eastern Regional High School.

If you have ANY questions, please contact Danyle Heilig at uprisefhc@gmail.com.
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Player's Last Name *
Player's First Name *
Position *
Birthdate *
MM
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DD
/
YYYY
Graduation Year *
USFHA Membership Number (you must be a member of the United States Field Hockey Association to play for a club program) *
For the 2021-22 club season, I am interested in participating in the following seasons - please select ONLY ONE: *
Required
Street Address *
City *
State *
Zip Code *
Email Address *
Phone Number *
Emergency Contact and Phone Number *
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.
Electronic Signature for Consent *
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