Arlington Soccer Association

ASA Player Registration Form

1. Print page, complete Player and Parent/Guardian Information, and sign form
2. Attach player fee. (See www.arlingtonsoccer.com for club and player fees.)
4. Give form and player fee to your coach or team manager.

Player Information

Player last name

First name

M.I.

M or F

Street (and Apt)

City

State & Zip

Date of birth

Age

School

<Grade

Phone

Email address

List any team & friends with whom you'd like to play.

Parent/Guardian Information

Hold Harmless Agreement

I hereby give my son/daughter permission to participate in the soccer program sponsored by the Arlington Soccer Association in conjunction with the Arlington County Department of Parks, Recreation and Cultural Resources. I am aware that there is the risk of personal injury from participation in this program and that every participant in this program should be insured for medical expenses arising from accidental injury through a policy which his/her family currently has in force and which will cover his/her participation in this sports program.

In consideration of permission being granted to participate in these activities and to use the facilities of Arlington County, I hereby agree to hold harmless and indemnify the Arlington Soccer Association and the Department of Parks, Recreation and Cultural Resources, their agents and employees from any claims or liability connected with my child or my family's participation in the soccer program. I have read and understand this HOLD HARMLESS AGREEMENT and by the submission of this registration form agree to its terms. This permission will remain in effect unless otherwise terminated by the parent or guardian in writing.

Parent/Guardian Code of Conduct
Parents/guardians are the most important role models for their children.
I agree to abide by the following:
  • I will foster good sportsmanship by demonstrating positive support for all players, coaches, and officials at every game, practice, or other sports events.
  • I will place the emotional and physical well being of my child before a personal desire to win.
  • I will support coaches and officials working with my child, in order to encourage a positive and enjoyable experience for all.
  • I will remember that the game is for the kids - - not the adults. I understand that the three top reasons kids play sports are: a) to have fun, b) to make new friends, and c) to learn new skills.
  • I will endeavor to make youth sports enjoyable for my child.
  • I will advocate a sports environment for my child that is free of drugs, tobacco, alcohol, abusive language and will refrain from their use during youth sports events.
  • I will encourage my child to play by the rules, respect the rights of other players, coaches, fans and officials, and follow the ASA Player Code of Conduct.

Signature

Date

Name (Please print)

Phone

ASA Registration Form 03/5/2007