Club Registration Form
Jersey Knights Soccer Club
Club Registration Form
Name: ____________________ Birth Date: __________Gender: Boy Girl
Address: _______________________________________________________________
Town/Zip :______________________________________________________________
* E Mail: ________________________________ Phone (H): _____________________
Phone (W): ____________________
Phone (C): _____________________
Mothers Name:____________________
Fathers Name: ____________________
Current Team & Flight: __________________________________________________
Required Medical Release:
Participation in any sport may cause physical injury, sprains, strains, etc. We, the undersigned, understand soccer is a contact sport and do not hold the Jersey Knights, its representatives, and employees responsible for injuries occurring during the course of the tryout process.
Date: __________ Signature: ____________________