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Group Two Sign Up


Player Info
Name of Player
Age DOB
Team Player Email
Parents Email
Street Address
City Zip
State  
 
Home phone Work phone
Cell phone  
 
Total amount $
 

Please read carefully the Important Notice& Waiver displayed on this page before signing this application.

Hereby, I CONFIRM of reading and understanding in full, Important Notice and Waiver announced by FC Phoenix LLC.

Parent/Guardian Info
I am: Mother
Father
Legal guardian
Name Phone
City Zip
List any medical problems or prohibition of player

please type in "x" or "none" if no info needed
Person to notify in emergency Phone
Doctor to notify in emergency Phone
Health Insurance Company name Group/Policy number
 

Please read carefully the Important Notice& Waiver displayed on this page before signing this application.
Hereby, I GIVE CONSENT for emergency.

 

* every field is obligatory

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