WTU Fall 2018 Try Out Registration
All tryouts will be at Clark University

Clark University’s Kneller Athletic Center 950 Main St, Worcester, MA

Saturday, August 18th
Boys and Girls Grades 3-7 3:00-4:30 p.m.
Boys and Girls Grades 8-11 4:30-6:00 p.m.

Clark University’s Dolan Field House 97 Beaver St, Worcester, MA

Sunday, August 26th
Boys and Girls Grades 3-7 3:00-4:30 p.m.
Boys and Girls Grades 8-11 4:30-6:00 p.m.

Plan to arrive 15-30 minutes prior to your tryout time for registration purposes.

Tryouts will consist of drill stations and scrimmaging. There is a $25 non-refundable fee due at the time of tryouts. You may pay in cash, check or money order made payable to Worcester Team United. A $25 charge will be applicable for all returned checks. We are not currently processing payments online.

Player Information
Player's Name *
Your answer
Player's Birth Date *
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/
DD
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YYYY
Player's Height *
Your answer
Player's Weight *
Your answer
Player's School *
Your answer
Player is entering grade: *
Have you played for WTU before? *
Previous Coach
Your answer
Player's Cell Phone # (if applicable)
Your answer
Player's Email Address (if applicable)
Your answer
Parent/Guardian Information
Parent/Guardian 1 Name *
Your answer
Parent/Guardian 1 Phone # *
Your answer
Parent/Guardian 1 Email Address *
Your answer
Parent/Guardian #2 Information
Parent/Guardian 2 Name
Your answer
Parent/Guardian 2 Phone #
Your answer
Parent/Guardian 2 Email Address
Your answer
Emergency Information
Emergency Contact Name & # (other than guardian above) *
Your answer
Player Allergies & Medical Conditions
Your answer
Medical Release
We understand that Worcester Team United (WTU) cannot assume responsibility for losses, damages or injuries which may occur as a result of participation in this program. We understand that the student athlete and/or parent is responsible for damage done to any WTU property and the cost of repair and/or replacement of that property. In addition to the terms laid out above, I also accept the responsibility of insuring that my children understand and accept these policies and objectives. To the best of my knowledge, my child is physically fit for participation in this sport, and is neither seeing a physician for any sports injury nor being treated with any medication that may affect his or her performance. MEDICAL AUTHORIZATION AND RELEASE: We, guardian(s) for our child named in the form above do hereby release and hold harmless the directors, coaches, medical attendants, and adult leaders of the WTU Sports Program from any and all liability for all losses, damages or injuries occurring as a result of our child’s participation in the program’s activities. We further agree to make or cause to be made, by assignment of third party benefits or otherwise, full and complete payment for examination, treatment or hospital care required in the case of medical emergency. We understand that reasonable precautions will be taken to make the program safe and beneficial for all children, but that risk of injury cannot be eliminated entirely, and that this release is necessary for our child to participate in the WTU Sports Program. Furthermore, we hereby authorize, in the event our child suffers injury, any director, coach, medical attendant, or adult leader of the WTU Sports Program to consent to emergency medical treatment for our child when we cannot be contacted to so consent. Such medical treatment may include, without limitation, x-ray examination, anesthetic, medical diagnosis, treatment, or hospital care being required, and is given to provide authority and power on the part of a director or coach of the WTU Sports Program to give specific consent to any and all such examination, treatment, or surgical examination or treatment and general hospital care. No prior determination of life-threatening emergency or danger of serious or permanent injury resulting from delay of treatment need be made under this authorization. This authorization is given in advance of any specific hospital care.
We have read understand and accept the Medical Authorization and Release Waiver above. I certify that I am at least 18 years of age and legally able to agree to these terms. *
Required
Waiver/Release/Authorization
Waiver/Release/Authorization to Use Likeness Names, Voice and Words: By submitting a membership application to WTU, the applicant authorizes WTU including without limitation, the Releases hereinabove, in perpetuity, without compensation, reservation, or limitation, to allow the reproduction, dissemination, and/or publication of the applicant’s name, nickname, image, voice, signature, facsimile, biological information, photograph, and/or likeness for media coverage, public relations, or any other purpose whatsoever, which may involve the use of photographs, films, and/or videotape recording and/or any other form of media, whether currently in existence or not, and understand that WTU retains title, exclusive and unlimited rights to all internet streaming files including live and archived games, interviews, and events broadcast to the Internet. WTU is under no obligation to exercise the rights herein granted. The applicant understands and agrees that he/she will not receive any payment for the possible commercial use of his/her name or likeness.
We have read understand and accept the Waiver/Authorization/Release above. I certify that I am at least 18 years of age and legally able to agree to these terms. *
Required
Please verify that all questions are properly answered and hit submit. We look forward to seeing you at tryouts.
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