Registration_Spring2010

If you played for MSC in the Fall, 2009 Season, you still need to complete this online registration form. If you did not play for MSC in the Fall, 2009 Season but you wish to play in the Spring 2010 season, you must also complete this form. If you did not play in the Fall 2009 Season, you may be asked to participate in an evaluation by our Director of Coaching. After you have completed this registration form, someone will contact you from MSC to verify receipt and to set up an evaluation if that is necessary. There is no charge to tryout at the Mobile Soccer Club. If your child is selected for a team, the Spring 2010 registration fee is $400.00 per player. For further details on what these funds cover, you need to contact Cynthia Mattson at Cindy@MobileSoccerClub.org. Please mail your payment to Mobile Soccer Club, P. O. Box 8363, Mobile, Alabama 36689 immediately upon registration. Your registration will not be complete until payment is received.
Returning MSC Player?
Player Last Name
Player First Name
Middle Initial
Date of Birth (MM/DD/YYYY)
Age (##):
Gender
School attending in Spring 2010
School Grade (##)
Years of Soccer Experience
Last Season Played
Last team on which you played
Position(s) played most
Other sports in which you participate?

















Will soccer be your primary sport?
If selected for a Mobile Soccer Club travel team, do you plan to play in any other league?
Other Soccer Leagues Answer?
Where?
What is the highest level in soccer that you have played?
Highest Level Achieved Answer
What is the highest level in soccer that you would like to attain?
Highest Level Desired Answer
By initialing below, you acknowledge that you understand that commitment to a competitive team is for the Fall AND Spring seasons and that the "Season" for select soccer commitment purposes is from August 1 through the next July 31. However, normally you will pay separately for the Fall and Spring. You may play high school soccer. The Mobile Soccer Club does not require you to skip high school soccer for club soccer. However, the Mobile Soccer Club may offer a Spring Program for those who elect not to play high school soccer. For those who play high school soccer, the Mobile Soccer Club will re-form teams after the middle school and high school seasons to play in the Mobile Soccer Club Spring Classic and possibly other tournaments. Please enter your initials below to acknowledge commitment level.
Acknowledgement of Commitment Level:
Street Address
City
State
Zip Code
Home Phone
Player's Email
Player's Cell Phone
Father's Name
Father's Email
Father's Cell Phone
Mother's Name
Mother's Email
Mother's Cell Phone
Emergency Contact's Name
Emergency Contact's Cell Phone
List Any Significant Medical Conditions
Other pertinent information:
BY SUBMITTING THIS REGISTRATION I CERTIFY AND AGREE TO THE FOLLOWING: Recognizing the possibility of physical injury associated with soccer and in consideration for the Mobile Soccer Club, Inc. and it’s affiliates accepting the registrant for its program(s), I hereby release, discharge and/or otherwise indemnify the aforesaid Mobile Soccer Club, the Alabama Youth Soccer Association, the City of Mobile, Alabama, US Club Soccer, the University of South Alabama and all of their affiliated organizations and sponsors, their employees and associated personnel against any claim by or on behalf of the registrant as a result of the registrant's participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.
I understand that medical insurance is not the responsibility of the Mobile Soccer Club, Inc., the Alabama Youth Soccer Associaion, the City of Mobile, US Club Soccer or the University of South Alabama and that primary insurance coverage is my responsibility.
My son/daughter is physically capable of participating in the program for which I am registering them. I hereby give my authorization and consent to have an athletic trainer and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment. I authorize and execute my consent for any and all medical and hospital care and treatment, including major surgery, deemed necessary by a duly licensed physician selected by my Attorney(s)-in-Fact for the health and well-being of my above named child and I agree to be responsible financially for the reasonable cost of such assistance and/or treatment.
I/we further give permission to have our child’s photographs/images used by MSC and its affiliates for news releases, website, advertising, brochures, flyers and any other media for informational or promotional purposes.
This Special Power of Attorney and Hold Harmless Agreement shall be effective upon submission of this registration and shall continue in effect until my child is no longer a participant in said program.
Jersey Size
Shorts Size
There is no charge to tryout for the Mobile Soccer Club. However, if selected, the Spring 2010 Season fee is $400.00. This fee will not cover all expenses associated with playing on a travel club soccer team. Please email Cindy Mattson at Cindy@MobileSoccerClub.org to obtain further information with regard to fees and expenses.
Date (MM/DD/YYYY)
Electronic Signature of Player
Electronic Signature of Parent
Please print a copy of this form and save it for your records.