Central PA UNITY CUP Registration (Individual)
If you are looking to join a team - fill out the form and we will place you for the tournament.
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Email *
Name (First/Last) *
DOB *
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DD
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YYYY
Cell Phone with area code *
Address  (mandatory for insurance) *
Email *
If placed on a team, which nation/region would you like to play for?  (Or write "It doesn't matter") *
Which position do you feel most comfortable playing? *
What jersey size (adult) do you prefer? *
RELEASE AND DISCLAIMER: Soccer is a contact sport involving risk of serious injury, disability, or death.  Not all risk are foreseeable.  In consideration of being allowed to participate, I agree to release, waive, and convenant not to sue United States Soccer federation or affiliates on account or injury, death, or property damage alleged to be caused in whole or in part by affiliate’s actions or omissions. (Eastern Pennsylvania Soccer Association) I HAVE READ THE RELEASE & DISCLAIMER AND RECOGNIZED THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING. I KNOWINGLY ASSUME THE RISK. :: Type Full Name as Signature :: *
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