2024 SELECT PLAYER EVALUATION REGISTRATION
Help us make this the best Evaluation experience you have ever had!  Please make sure to fill out all of the information completely before coming to the Field.  
Completeness is Key: Fill out all information fields completely. Post-Submission Confirmation: Expect a Confirmation message after form submission.
Place & Time Details: Your Confirmation will include Player Evaluations' Place & Time.
Questions?: Call 877-385-6972 or Email select@lnysa.org

We look forward to seeing you & your athlete on the field at the Select Player Evaluations! 
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What Select Player Evaluation will your Player Attend? *
See the Schedule listing on our website if you are not sure 
Player First Name: *
first name
Player Last Name: *
last name
Player date of birth: *
use format Month/Day/Year
MM
/
DD
/
YYYY
Player Gender *
Your Players Year of Birth *
What is your Players year of birth as stated on their Birth Certificate
Which School does your Player currently Attend?: *
If you Add Other please List in the next Question
If you chose Other in Schools please list the name here
Which Grade is your player in? *
Preferred Role on the Field:
Does your player play on field or goal, both or no preference 
Has this player attended LNYSA Select Evaluations/Tryouts in the past:
Clear selection
Tell Us about your child's Soccer History?
Parent/Guardian Name: *
First and Last
Parent/Guardian Email Address: *
You will receive updated information from time to time about the Evaluations
Parent/Guardian Cell Phone: *
Required in case of Emergency Contact
Which City do you Live in: *
By submitting this form I am releasing LNYSA, Inc., its employees, agents, volunteers and coaches from responsibility of any injury or damages that might occur as a result of attending the Select Player Evaluations. I hereby authorize LNYSA, Inc. staff to act for me according to their judgment in any emergency requiring medical attention and I hereby waive and release LNYSA, Inc and its Directors and Coaches from any and all liability stemming from any injuries or illnesses incurred while at Select Player Evaluations.  I have no knowledge of any physical impairment which would be affected by participation in the Select Player Evaluations as outlined. I understand this Select Player Evaluations consists of strenuous physical activity. *
TYPE YOUR LEGAL NAME BELOW - Parents should please review the above release and Type your LEGAL NAME below.
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