Sacramento Soccer Alliance

2012 SSA Tryout Registration Form

Player Info:

Last Name

First Name

Birthdate

If other please specify

Parent Info:

Last Name

First Name

Address:

Street

City

Zip Code

Cell Phone

Comments or Notes

I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of CYSA and US Club Soccer, its affiliated organization and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the accepting the registrant for its soccer program and activities ("The program"), I hereby release, discharge and otherwise indemnify CYSA and US Club Soccer, its affiliated organizations and others, their employees and associated personnel, including the owners of the fields and facilities utilized for the program against any claims by or on behalf of the registrant as a result of the registrantâ€™s participation in the program and/or being transported to or from the game, which transportation I hereby authorize.


	Play hard, play fair, have fun!

2012 SSA Tryout Registration Form

Age Group Matrix