ssa assessment tryout registration form.pdf
For SSA use only: Swansboro Soccer Association DOB________ Age Group______ (Boy/ Girl) Competitive
Academy
Birth Cert
$25.00 Registration Fee: Check
Check#___________ Cash
Other
________________
_________
Assessment/ Tryout T-Shirt# ____________ Contact Information: Primary phone (s)___________________________________________ number (s) the Coach or SSA can call Primary Email (es)_____________________________________________________________ Address:_____________________________________________________________________ Parent/Guardian #1 Name:______________________________________________________ Relationship to Player:__________________________________________________________ Player Info: Player Frist Name:______________________ MI:______ Last Name:_______________________________ Nick Name:_______________________ Gender:____________ Most Recent Soccer Club associated with:_____________________________________________________ Position Played:__________________________________ Total Years Played:____________________ Medical Emergency Contact: Name:_________________________________________ Phone:_______________________ Known Medical Conditions:____________________________________________ N/A Parent/ Guardian Signature_________________________________________ Date_____________ ***Registration fee is $25.00 and can be paid by Check, Cash, or Credit Card; Please make checks payable to SSA.
Please bring completed registration form along with a copy of player’s birth certificate on the first night of attendance. OR…mail completed registration form with check or money order to SSA at PO Box 104 Swansboro, NC 28584 “Attention Registrar”. Please have a copy of your child’s birth certificate available at assessments/tryouts, even if you have turned in a copy before to SSA.
Academy
Birth Cert
$25.00 Registration Fee: Check
Check#___________ Cash
Other
________________
_________
Assessment/ Tryout T-Shirt# ____________ Contact Information: Primary phone (s)___________________________________________ number (s) the Coach or SSA can call Primary Email (es)_____________________________________________________________ Address:_____________________________________________________________________ Parent/Guardian #1 Name:______________________________________________________ Relationship to Player:__________________________________________________________ Player Info: Player Frist Name:______________________ MI:______ Last Name:_______________________________ Nick Name:_______________________ Gender:____________ Most Recent Soccer Club associated with:_____________________________________________________ Position Played:__________________________________ Total Years Played:____________________ Medical Emergency Contact: Name:_________________________________________ Phone:_______________________ Known Medical Conditions:____________________________________________ N/A Parent/ Guardian Signature_________________________________________ Date_____________ ***Registration fee is $25.00 and can be paid by Check, Cash, or Credit Card; Please make checks payable to SSA.
Please bring completed registration form along with a copy of player’s birth certificate on the first night of attendance. OR…mail completed registration form with check or money order to SSA at PO Box 104 Swansboro, NC 28584 “Attention Registrar”. Please have a copy of your child’s birth certificate available at assessments/tryouts, even if you have turned in a copy before to SSA.
