SFYS PICK UP SOCCER REGISTRATION

Player Registration

Spring 2020:
Pick Up will be played at POLO FIELD, pitch #7

Every Sunday from 3-8 to 5-17,

12-2pm.

Cost and Waiver
FREE -

Signing up using this form includes completion of the participation waiver.

Player First Name: *

Player Last Name: *

Player DOB (month/day/year) *

Player Gender *

Player School: *

Player Email (if available):

Confirm Player Email Address:

I understand that I can attend any or all of the SFYS Pick Up Soccer meetings. *

Yes

CHECK THIS BOX to receive updates about HS pickup

Parent / Guardian Information

Parent/Guardian First Name: *

Parent/Guardian Last Name: *

Parent/Guardian Email: *

Confirm Email Address: *

CHECK THIS BOX to receive updates about HS pickup

Parent/Guardian Main Phone Number: *

Parent/Guardian Mobile Phone Number:

Street Address: *

Address Line 2:

City: *

State: *

Zip: *

Alternate Emergency Contact Information:

First Name: *

Last Name: *

Main Phone Number: *

Email: *

Medical and Liability Release

I, the parent/legal guardian of the above-named player, a minor, or a player age 18 or over, agree that I and the player will abide by the rules and regulations of San Francsico Youth Soccer, San Francsico Vikings Soccer Club and its affiliated organizations. I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify SFYS/SFVSC and SFYS/SFVSC Parties, the owners and operators or the facilities used for the programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player’s participation in the Programs including, without limitation, player’s transportation to/from any Program, which transportation is hereby authorized. I further grant the SFYS and SFYS Parties the right to use player’s name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player’s status as a participant in the Programs. As the parent/legal guardian of the above-named player, or player age 18 or over, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of me or my dependent.

I have read and agree to the medical and liability release *

Yes - I agree to the medical and liability release

No - If I pick no, I understand that my child cannot play/participate in the league

I am the person authorized to confirm this medical and liability agreement: *

I am the Parent or Legal Guardian as named above

I am the Player named above, if age 18