Commonwealth Soccer Club

Tryout Registration Form

The following registration information is required by CSC.

This form must be filled out prior to tryouts.

Last Name	First Name	Middle Name
Gender (M/F)	Date of Birth
Street	City	State
Zip
Parent or Guardian Name (First, Last, MI)
Home Phone	Cell Phone
Current School	Fall Grade
Email Address 1	Email Address 2	Email Address 3

Medical Waiver - Please read and accept or decline by entering "Yes" or "No" in the space provided below.
I authorize the representatives and staff of Commonwealth Soccer Club to act according to their best judgment in case of any emergency. I will not hold Commonwealth Soccer Club or any representative or staff member responsible for any unforeseen injury or illness.
Agree to Medical Waiver (Enter Yes or No)		Players Last 4 SSN