MDSA Player Withdrawal Form
The $25 AYSO Annual Membership Fee is non-refundable and will not be returned as part of a player withdrawal request. The player will continue to be an AYSO Member for the duration of the  Player Year (August 1 through July 31). Please see www.ayso.org for more information.

For specific season dates and the full refund policy, please visit www.mdsoccer.org

If there are special considerations, please include them in the Notes/Comments section of the Player Withdrawal Request. They will be reviewed by the Registrar and Regional Commissioner.
Sign in to Google to save your progress. Learn more
Player Name *
Date of Birth
MM
/
DD
/
YYYY
Division/Age Group
Email *
Person Submitting Request *
Phone
Address
Notes/Comment/Reason for withdrawal *
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
This form was created inside of Mt. Diablo Soccer.