Houston Select SA Tryout form

Player Information

Player Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Player DOB*

Guardian/ Parent E-mail*

example@example.com

Guardian/Parent Cell *

Area CodePhone Number

Number of years playing*

	1	2	3	4	5	6	7	8	9	10

1 is Years, 10 is Years

What club/organization were they with if any?

Club name

Release of Liability

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to this tryout.
I give consent for the facility to secure any and all necessary emergency medical care for my child.

Although the safety of all sport activities is the primary concern, soccer activities may cause injuries. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against Houston Select coaches and the persons in charge.

I have read and agree to the above conditions*

YesNo

Signature*

Clear

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at mario@houstonselectsa.com