1. Complete form below. Make sure a parent or
guardian signs at bottom in part 4. 2. Attach player fee. 3. Give
form and attachments
to: Your coach or team
manager, or mail to -
Arlington Teen Soccer Registrar, 4419 S. 4th Street, Arlington, VA
22204-1405.
1. Player
Information
Player last name
First name
M.I.
M or
F
Street (and Apt)
City
State
Zip
Date of birth
Age
School
Year will graduate
Phone
Email address
List any
team & friends with whom you'd like to play.
2. Proof of
age
• Proof of
age for new
players
You do not need a proof of age for the
Teen Soccer Club if you have played previously on an Arlington Soccer
Association team,
For first time players, the date of birth attested to on this form will serve as proof of age
3.
Fee
•Make checks payable to: "Arlington Soccer
Association" •Donations are used to
help pay teen player fees.
Player fee:
$ 35
Donation:
Total:
$
4.
Parent/Guardian Permission
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
Community Resources. I understand 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. With this permission, I hereby release the Arlington
Soccer Association and the Department of Parks, Recreation and
Community Resources, its' agents and employees from any liability
incurred in the conduct of this program. This permission will remain
in effect unless otherwise terminated by parent or guardian in
writing.