Section I: Player Information

Soccer Experience * 🛈
Played for Yorktown FC? *

Section II: Parent/Guardian (Point of Contact for Tryouts)

Relationship to Participant: *

Section III: Medical Conditions

Section IV: Consent and Liability Waiver

I certify that I am the parent or legal guardian of the player listed above (or at least eighteen (18) years old) and attest all of the information provided on this form is true and accurate. I hereby give consent for the above named player to participate in Yorktown FC Tryouts. I accept all risks associated with this participation. I recognize that minor to severe injuries can occur in soccer activities. I authorize Yorktown FC and its staff members to act for me in securing medical treatment in the event I am unreachable after an injury or emergency regarding my player.

 * 🛈
I further certify the above named player has personal medical coverage. I release, indemnify and hold harmless the Yorktown FC Soccer Club, its director, coaching staff, volunteers, and facility from any claim, demand, or action arising in connection with my player’s participation. * 🛈