AZSC Thunder
Assessment / Tryout Registration


** Denotes a Required field
Child Information
** Last Name:
** First Name:
Middle Initial:
** Date of Birth:

** Gender:

** Any Medical Conditions?

If so, What?


Parental Information
** Last Name:
** First Name:
** Street Address:
Apt/Unit:
** City:
** State:
** Zip:
Home Phone:
** Cell Phone:
Work Phone:
Employer:
Occupation:
** Email:
   

Soccer History
Previous Club:
Previous Team:
Are you available to play Sundays?

Previous Team classification: Select one:
Position: Check ALL that apply: Forward: Left Center Right Midfield: Left Center Right Defender:
Left Stopper: Right Sweeper: Goal Keeper:
** Age Division for Next Season:
Age Division Table

How did you hear about us? Check one: Coach: School Flyer: Newspaper Ad:
Internet - AYSA: AZSC: Other:
Comments:


 
ACKNOWLDEGEMENT AND ASSUMPTION OF RISK: I acknowledge that entering and using Crossroads Park (the "PARK") while rented by Arizona Soccer Club United ("AZSC") carry risks. These risks can cause serious injuries and even death. Serious injuries also may occur during games or other activities I or my family or guests may participate in or observe while on the premises, including injuries which may result from the action, inaction or negligence of the Released Parties (defined below) or the intentional wrongdoing of others (including other players or spectators). By signing this form below, either via electronic acknowledgement or by hard copy, I knowingly and voluntarily assume these and all other risks for myself, my spouse and my minor child.

RELEASE AND WAIVER: In consideration for the right to use the PARK and/or allow my minor child to participate in an AZSC sanctioned event, I, and on the behalf of, as applicable, my minor children, heirs, personal representatives and assigns, hereby (a) release and hold harmless AZSC, the Town of Gilbert: and the officers, members, directors, contractors, employees, elected officials, referees, sponsors, advertisers, volunteers and agents of any of the foregoing (collectively the "Released Parties") from or with respect to any and all premises or other liability, from any cause whatsoever (including, without limitation, negligence in rendering, or not rendering, medical or emergency aid), for any and all loss of life, bodily injury, property damage and/or other loss I or my minor children may suffer or incur in, about or en route to or from the PARK premises, whether or not any such loss is caused in whole or in part by the action, inaction or negligence of any Released Party; and (b) waive any and all rights I or they may have to make a claim against or to sue any Released Party for any such loss of life, injury, damage or other loss or from any suspension or they may be issued as provided in the paragraph below.

CONDUCT: To create and maintain a safe, family environment at the PARK, AZSC has established rules and regulations, I agree to abide by all such rules and regulations. I understand and agree that I may be suspended from the PARK for dangerous, violent, abusive, offensive, disruptive or other comparable conduct or for any violation of the rules or regulations and agree to indemnify the Released Parties from the consequences of any such conduct or violation, including attorneys fees and costs.

INSURANCE AND OTHER PROVISIONS: I understand that AZSC does not maintain health, medical or disability insurance for my benefit or the benefit of my family and that I will be responsible for the cost of any medical services incurred by or for us unless I obtain my own insurance. I acknowledge AZSC is not responsible for theft, lost items, property damage or vandalism. I consent to the use of my image and likeness in AZSC advertising and promotional materials without compensation. I authorize representatives of AZSC to obtain emergency treatment for me or my minor children in the event of illness or injury. If any provision hereof is found to be invalid or unenforceable, such determination shall not invalidate or render unenforceable any other provision.


** By marking this checkbox, you acknowledge, understand and assume all risk and liability.