Missouri Permission to Secondary Roster Form
Missouri Permission to Secondary Roster Form This form must be completed and signed by all parties for acknowledgement & authorization of a youth player to secondary register with another team outside of their own club during a seasonal year. Both clubs are responsible for securing and retaining a copy of this document, the Secondary Club is responsible for sending a fully signed copy to the State Office prior to rostering of player. Any misrepresentation made on this document can result in coach/parent/player suspensions of up to one year.
Name of Player: ___________________________ DOB: _______ ID# ________________
Current Club: ________________________________________ Age/Gender: ________ Primary Rostering Team of Player: ________________________________ Primary Coach Name: ____________________________ Phone: _____________________
Club/ Team Seeking Secondary Roster: ________________________________________ Secondary Club Coach Name : _________________________________________ (print) Phone: ___________________ Seasonal Year: ________________________________ By signing below I verify that all information above is accurate and acknowledge that the player has permission to secondary roster with another club. I understand that this permission does not grant or authorize a player transfer.
Primary Coach Signature: __________________________________________ Date: ____________ Primary Club Registar Signature: ____________________________________ Date: ____________ Secondary Club Registar Signature: _________________________________ Date: _____________
Name of Player: ___________________________ DOB: _______ ID# ________________
Current Club: ________________________________________ Age/Gender: ________ Primary Rostering Team of Player: ________________________________ Primary Coach Name: ____________________________ Phone: _____________________
Club/ Team Seeking Secondary Roster: ________________________________________ Secondary Club Coach Name : _________________________________________ (print) Phone: ___________________ Seasonal Year: ________________________________ By signing below I verify that all information above is accurate and acknowledge that the player has permission to secondary roster with another club. I understand that this permission does not grant or authorize a player transfer.
Primary Coach Signature: __________________________________________ Date: ____________ Primary Club Registar Signature: ____________________________________ Date: ____________ Secondary Club Registar Signature: _________________________________ Date: _____________
