| * required field |
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| First Name*: |
Last Name*: |
| Address*: |
| City*: |
State*: |
5 Digit Zip Code*: |
| Date of Birth*: Must be between 8 and 18 years old |
Height*: |
Weight*: |
Sex*: MaleFemale |
| School*: |
Grade*: |
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| Previous Soccer Club: |
| Position #1: |
Position #2: |
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| What foot does the player favor?* |
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Player Jersey Number*
First Choice:
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Second Choice: |
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| Have you played with the Lake Worth Sharks before?* YesNo |
| If yes, what year: |
Coach Name: |
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Parent / Guardian Information
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| Parent #1 / Guardian Name*: |
Cell Phone*: |
| Email Address*: |
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| Parent #2 / Guardian Name: |
Cell Phone: |
| Email Address: |
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| How did you hear about us*: |
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| Please list any Medical Conditions*: |
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| Initial*: First & Last Initial |
Parent / Guardian Consent Form: I do hereby expressly and specifically assume all of the risks which attend the game of soccer and any other sports or related activities. including but not limited to physical contact and physical injuries. I agree to indemnify and hold harmless Lake Worth Sharks FC, its officials, coaches, and members including but not limited to any adjoining facilities from any and all claims, suits, or proceedings arising allegedly or in reality out of the acts or omission and participation of the undersigned in any related activity. I also agree to all rules and regulations of the Lake Worth Sharks FC. |
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| Initial*: First & Last Initial |
Consent for Medical Treatment (minor): As the parent or legal guardian of the above player, I hereby give consent for emergency medical care prescribed by a duly licensed doctor of medicine or dentistry, This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of this minor, named above. |
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| Initial*: First & Last Initial |
Confirmation of tryout procedures As the parent or legal guardian of the above player, I confirm that he / she is not currently registered with any other soccer club and that he is a free agent. |
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As the parent or legal guardian of the above player, I confirm that I have read and fully understand the procedures and policies of the tryout process.
Signature*: First & Last name of parent / guardian |
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