Northwest Soccer Club

Subscribe to our Newsletter

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

Home Phone:

* Birthdate:

* Email:

* Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Printed, Completed and Signed Waiver from the Handout section (bring with you to Try-outs) *

* County Waiver Signature (Type Your Name):

Printed, Completed and Signed COVID Waiver from the Handout section (bring with you to Try-outs) *

* COVID Waiver Signature (type your name):

Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

* Email:

Home Phone:

Work Phone:

Cell Phone:

Names of Soccer Clubs you are trying out for:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Parent, Guardian or Adult E-mail:

* indicates required fields

OUR SERVICES