Registration for Try Outs

Parent Information

The following information is about the parent or guardian of the player.

Parent/Gaurdian Name

First Name

Last Name

Parent Phone

Country

(###)

###

####

Parent Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Player Information

The following information is about the player who will be trying out.

Player Name

First Name

Last Name

Player Nickname

Player Phone

Country

(###)

###

####

Player Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gender

Player Birthdate

MM

DD

YYYY

Country of Birth

Previous Clubs

What clubs has the player been apart of?

School Name

Grade

By submitting the above form, you provide Release of Liability:

You, the parent/guardian of the registrant, a minor, agree that the registrant and you will abide by the rules of Kalabash Academy, its affiliated organizations and sponsors. Recognizing the possibility of injury associated with soccer and in consideration for Kalabash Academy accepting the registrant for its soccer programs and activities, I hereby release, discharge and/or otherwise indemnify Kalabash Academy, its affiliated organizations and sponsors, their Board of Directors, their employees and associated personnel, including the owners of fields and facilities utilized for the programs, against any claim by or on behalf of the registrant as result of the registrant’s participation in the programs and/or being transported to or from the same, which transportation I hereby authorize. You give my permission for all medical care deemed necessary by a duly licensed doctor of medicine in my absence, for your dependent.