FIRE FC TRY-OUT REGISTRATION FORM 2016-2017 Tryout will be ...

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FIRE FC TRY-OUT REGISTRATION FORM 2016-2017 Tryout will be on May 31st-June 3rd at Canyon View Park (Please see your times below)

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Pre registration is suggested. Drop off or mail form to Fire FC, 552 25 Road Unit B, Grand Junction, CO. 81505 Check www.grandjunctionsoccer.org for updates under the tryout tab. All tryout results will be posted on-line Please make every effort to attend all available tryouts. If you will not be able to attend tryout, please e-mail Shaun Howe at [email protected]. Please include child’s playing age. Please arrive 30 minutes prior to your tryout time to complete the check-in process. Please wear a white or gray t-shirt and shinguards. Please bring water and a ball. Tryouts for players U11-U18 All Tryouts at Canyon View Park:  

2005 Girls May 31st and June 2nd 5:30-6:45 PM —Horsethief 2006 Girls May 31st and June 2nd 5:30-6:45 PM —Bear

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2002 Boys May 31st and June 2nd 2003 Boys May 31st and June 2nd 2004 Boys May 31st and June 2nd 2005 Boys May 31st and June 2nd

6:45-8:00 PM —Bear 6:45-8:00 PM —Bear 6:45-8:00 PM —Bear 6:45-8:00 PM —Ruby

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2002 Girls June 1st and June 3rd 2003 Girls June 1st and June 3rd 2004 Girls June 1st and June 3rd 2006 Boys June 1st and June 3rd

5:30-6:45pm — Ruby 5:30-6:45pm — Ruby 5:30-6:45pm — Ruby 5:30-6:45pm — Yellow Jacket

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2000 Girls June 1st and June 3rd 2001 Girls June 1st and June 3rd 1999 Girls June 1st and June 3rd 1998 Girls June 1st and June 3rd

6:45–8:00pm — Bear 6:45-8:00pm — Bear 6:45-8:00pm— Bear 6:45--8:00pm—Bear

PLAYERS NAME:

CURRENT JERSEY #

PLAYERS DATE OF BIRTH: AGE GROUP for fall 2015: GENDER:

M

F

MOTHER: FATHER: ADDRESS: HOME PHONE:

CELL:

PARENT EMAIL ADDRESS: MEDICAL CONDITIONS:

***For Fall 2016, please circle highest level team you would accept a spot for*** Premier,- Colorado State League

Yes

United - Western Slope League

Yes

Recreational options available for U11 and 14 players. Yes Medical Release and Liability Waiver This is to certify that the above-named player has my permission to participate in Grand Junction Soccer Club tryouts. I have listed any known physical or health restrictions on this player’s ability to participate in tryouts. I understand that participation in this sports activity could result in injury to my child and I do hereby release on behalf of myself and my child, GJSC, its employees and agents, volunteers, members, and officials from any liability during tryouts. As the parent or legal guardian of the above-named player, I hereby give my consent for emergency care prescribed by a duly licensed Doctor of Medicine or doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

Parent Signature: