Competitive Tryout Registration

Please Fill Out Completely

Incomplete forms may result having to fill out a new form at tryouts. This form must be filled out for ALL children being registered to tryout (one form per child). Payment of fees are due in the Briarwood Church Quest Recreation Office no later than August 8, 2013.

Prefer a paper form? Download the form to mail in here

Note: A copy of the player's birth certificate must be filed with the club office. If your child is a returning player, one should be on file already. If unsure, please provide a copy to the office. YOUR CHILD CANNOT PLAY UNLESS A COPY IS ON FILE.

* indicates required field

New BSC Player?

*Player's Name:

*Address:

*City/State/Zip:

*Home Phone (xxx-xxx-xxxx):

*Email:

*Player's Birthday (mo/dy/yr): Current Age:

*Gender: Grade: School:

Church (if any):

Father's Name:

Alternate Phone (xxx-xxx-xxxx):

Mother's Name:

Alternate Phone (xxx-xxx-xxxx):

Doctor: Phone:

Health Issues:

*Emergency Contact (not mother or father):

Relation to player:

*Phone:

*Has your child played soccer before? Yes No

If yes, please include prior playing experience:

2011/2012:

Club/Team

Coach

Season Played

Positions Played (best 2)

League

2012/2013

Club/Team

Coach

Season Played

Positions Played (best 2)

League

*Age Group for Fall 2013 Season - Please Select One:

Names and age groups of other children playing:

Briarwood Soccer Club is a volunteer organization. The giving of your time and talents

is vital to helping our club achieve our mission. Please indicate how you can help:

Coach:

Assistant Coach:

Team Manager:

Service (concessions, field prep, office work, etc.):

*If selected to a Briarwood Ambassadors Competitive team, is this your first choice?

Yes No

*If selected, will you play fall and spring? Yes No

If no, why (play for school, another sport, etc)?

*Will you be participating in any other sport during the fall season? Yes No

*Spring season? Yes No N/A

If yes, what sport and which season?

*If selected, you will need to sign up online by June 19, 2013 if you choose to accept a spot on our team and payment must be received by August 9, 2012.

Please initial that you have read the BSC Tryouts Policy (opens in new window):

CONSENT STATEMENT: I, the parent/guardian of the registrant, a minor, agree that

the registrant and I will abide by the rules of the Briarwood Soccer Club (BSC) and its

affiliates. Recognizing the possibility of physical injury associated with soccer and in

consideration for BSC accepting the registrant for its soccer programs and activities (the

Programs), I release, discharge, and/or otherwise indemnify BSC, its affiliates, other

employees and associated personnel, including the owners of the fields and facilities

used for the Programs, against any claim by or on the 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 authorize. I give consent for emergency medical

care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care

may be given under whatever conditions necessary to preserve the well-being of my

dependent.

*By typing your full name and the date, you (the parent/guardian) agree to the above statement and verify that the information given is correct to the best of your knowledge:

*Date (mo/dy/yr):