Challenge Try-out Application

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NTSC Classic/Challenge Try-out Application Last Name:

First Name:

Address:

City:

State:

Male/Female:

Date of Birth:

Phone #:

Father's Name:

Mother's Name:

Emergency Contact:

Email Address:

Cell Phone:

Emergency Contact Number:

Born Between 8/1/2005 7/31/2006 8/1/2004 7/31/2005 8/1/2003 7/31/2004 8/1/2002 7/31/2003 8/1/2001 7/31/2002 8/1/2000 7/31/2001 8/1/1999 7/31/2000 8/1/1998 7/31/1999 8/1/1997 7/31/1998

Age Group U10 U11 U12 U13 U14 U15 U16 U17 U18

Nick Name: Zip Code:

I am a Goal Keeper: I am trying out for

age Group.

I would consider playing up an age (yes/no): I understand I can try out for my current age or 1 age older. Any other request must have prior approval by the NTSC BOD

Classic Level of Play: Classic play, I understand that I am making a commitment to the highest level of play in NTSC. I am expected to come to all practices, games and team events. At the Classic level of play, I am not guaranteed any specific amount of playing time per game . NTSC designates all practice locations and Home Game locations. I also understand that this is a travel team that may require travel across NC. Challenge Level of Play: Challenge play, I understand that I am making a commitment to NTSC. My play time will be in line with that commitment. At the Challenge level of play, we encourage 50% playing time per game, but it is not guaranteed. NTSC will consider Stokes vs. Surry county for practice and games when appropriate, however this team travels to other locations within NC to play games. Club Fee Structure

Classic Challenge Boys & Girls U11-U14 Fall / Spring $200 $175 Boys U15-U18 Spring Only $150 $125 Girls U15-U18 Fall Only $150 $125 Note: additional fees will incur throughout the season(s): Referee Fees, Uniform Costs, Coach Fees/Expenses, and Tournament Fees Team Acceptance If I make a team, a non-refundable 1st installment of $50 is due by June 2, 2015 Current participation on an NTSC competition team does not guarantee placement on a future NTSC Competition team. _______I, as the legal parent or guardian, hereby give permission for this player to participate in the Northern Triad Soccer Club (NTSC) Tryouts. I hereby release and forever discharge NTSC, and its coaches, agents, and the owners of any fields used, from any liability for any PERSONAL INJURY or ILLNESS, DAMAGE or LOSS WHILE PARTICIPATING IN THIS ACTIVITY. My signature indicates that I understand and agree to the NTSC terms regarding Competition tryouts Signed:

Relationship:

Date: This is a try-out registration form only. Should you make a team, an NTSC registration is required.