Kentwood Soccer Club

2011-2012 Season Try Out Registration
Please fill out the following information. Required fields are marked with an *. If you have already registered and just need to reprint your Medical Release Form, go here.

*Player Last Name:

*Player First Name:

Player Middle Name:

*Address 1:

Address 2:

*City:

*State:

*Zip:

*Parent/Guardian Name(1):

Parent/Guardian Name(2):

*Home Phone (123-456-7890):

Work Phone (123-456-7890):

Mobile Phone (123-456-7890):

Primary Email:

Alternate Email 1:

Alternate Email 2:

*Player Birth Date:

(mm/dd/yyyy)

*Player's School in Fall:

*Player's Current School Grade:

*Trying Out for:

GVSA Age Group Chart

Group	Born Between
U19	08/01/1992 - 07/31/1994
U17	08/01/1994 - 07/31/1995
U16	08/01/1995 - 07/31/1996
U15	08/01/1996 - 07/31/1997
U14	08/01/1997 - 07/31/1998
U13	08/01/1998 - 07/31/1999

GVSA Age Group Chart - cont.

Group	Born Between
U12	08/01/1999 - 07/31/2000
U11	08/01/2000 - 07/31/2001
U10	08/01/2001 - 07/31/2002
U9	08/01/2002 - 07/31/2003
U8	08/01/2003 - 07/31/2004

Medical Release Form

Release of All Claims

For and in consideration of our child's participation in the Falcons KSC in West Michigan, we hereby release, acquit, forever discharge, indemnify, and hold harmless, Kentwood Soccer Club, all Kentwood Soccer Club sponsors, and their respective officers, directors, employees, agents and representatives of and from any and all claims, demands, actions, or causes of action, liability, or damage arising out of or in any way related to participation of our child in any Falcons KSC game or related activity.

You must agree to the medical waiver above in order to register and attend try-outs.

I Agree