Roseville Premier 2021/2022 Tryout Registration
Thank you for registering your player for the Roseville Premier 2021/2022 Tryouts. Please complete the following information:
Tryouts will be at the Roseville Maidu Soccer Complex. Current scheduled tryout/evaluation dates are:
Youngers May 24-26 (2013 through 2008)
Olders June 7th-9th (2007 through 2003)
Alternative Email Address
Contact Phone Number
Player First Name
Player Last Name
Age Group (Year your player was born)
2014 (U8 Premier Academy)
We want to tryout an age group higher / ignore if 'no'. (please note that players may only try out for the green team one age group higher)
2019 or 2020 Level of Play
Did not play last year
Are you a returning player?
Yes, I played for Roseville Premier Last Year
No, I did not play for Roseville Premier Last year
If no, where did you play last year?
I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment should it become necessary during, before or after the tryout activity. I agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge, and otherwise indemnify Roseville Youth Soccer Club and Roseville Premier, US Club Soccer, Cal North, their sponsors, the USSF and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the soccer player named above.
Medical Treatment Auth. and Liability Waiver
By checking this box I agree to the waiver.
Roseville Youth Soccer Club, a California Corporation (“the Club”) is taking precautions to reduce the spread of the novel coronavirus (“COVID-19”); however, the Club cannot guarantee that its players (and their family members), coaches, referees, and/or spectators will not become infected with COVID-19. By signing below, each player named above (“Player”), by and through the Player’s parent or legal guardian (“the Undersigned”) understands and agrees and voluntarily assumes the risk that, by playing soccer and/or engaging in soccer-related activities, the Player may be exposed to or infected with COVID-19 and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death to the Player or a member of the Player’s family. The Undersigned acknowledges the risk of the Player becoming exposed to or infected with COVID-19 and further acknowledges that an exposure or infection may result from the actions, omissions, or negligence of the Player and others, including, but not limited to, the Club and its employees, agents, board of directors, officers, and volunteers. The Undersigned hereby releases, discharges, and otherwise agrees to indemnify the Club, US Club Soccer, their sponsors, the USSF and its affiliated organizations, and the employees, board members, officers, and associated personnel of these organizations, against any claim by or on behalf of the Player as a result of the Player’s participation in US Club Soccer or Club programs, including as a result of any COVID-19 related exposure or infection.By voluntarily singing this Agreement, the Undersigned expressly agrees, for his or herself, for the Player, and for any family members, to release and hold harmless the Club, its employees, agents, board of directors, officers, volunteers, and representatives, of and from any and all claims, including all liabilities, causes of actions, defenses, damages, equitable rights, attorneys’ fees, and costs or expenses, of any kind arising out of or relating to playing soccer and/or engaging in soccer-related activities, including as to any COVID-19 related infection or exposure. The Undersigned understands and agrees that this release includes any claims related to COVID-19 based on the actions, omissions, or negligence of the Club, its employees, agents, board of directors, officers, volunteers, and representatives, whether COVID-19 exposure or infection occurs before, during, or after playing soccer or engaging in soccer-related activities. The Undersigned further expressly agrees that this Agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THIS RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
Covid Liability Waiver
By checking this box I agree to the waiver.
Please type full name in lieu of signing below
A copy of your responses will be emailed to the address you provided.
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