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About Quickstrike FC
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Mission statement
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04 Girls NYPL
03 Girls NYPL
02 Girls NYPL
01 Girls NPL
00 Girls NPL
99 Girls NPL
98 Girls NPL
05 Boys NYPL
04 Boys NYPL
04 Boys United NYPL
03 Boys NYPL
02 Boys NYPL
02 United Boys NYPL
01 Boys NYPL
01 Boys United NYPL
00 Boys NYPL
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NCAA Eligibality Center
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Quickstrike Ulster FC
Tryout Registration
Youth Player Registration Form
Current Club Name:
City:
State:
League Name:
I hereby consent to the above-named club registering me with US Club Soccer. I understand that I may be registered to only one US Club Soccer member club at any time. [Note: it will not be necessary to complete this form again as long as the player is with this club, which will hold this form unless requested by US Club Soccer.]
Player's Medical Information
Player's Name:
Birth Date:
Gender:
Male
Female
Street Address:
State:
Zip:
City:
Email Address:
Parent Name:
Home Phone:
Bus Phone:
Email Address:
Cell Phone:
Receive texts?
Yes
No
Parent Name:
Home Phone:
Bus Phone:
Email Address:
Cell Phone:
Receive texts?
Yes
No
In an emergency when parent/guardian cannot be reached, please contact the following:
Name:
Phone 1:
Phone 2:
Name:
Phone 1:
Phone 2:
Please list Allergies the player has:
Please list other medical conditions:
Physician:
Phone 1:
Phone 2:
Medical/Hospital Insurance Company:
Phone:
Policy Holder's Name:
Policy Number:
Medical Treatment Authorization And Liability Waiver
I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge, and otherwise indemnify the club, US Club Soccer, their sponsors, the USSF and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the soccer player named above as a result of that player's participation in US Club Soccer programs and/or being transported to or from the same, which transportation I hearby authorize.
Relation to Player:
Father
Mother
Guardian
Enter the code shown
*