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Contact Soccer
72 Wedgemere Ave.
Winchester, MA 01890
781.721.1690

 

  

Family Registration Form

This form only needs to be filled out if...

  • You have never filled it out before
  • You are changing information in which case you only need to enter enough information to identify yourself and any changes

1. Family Information

1.1 Adults

Please include any adults that we might have interactions with regarding the participants of Contact Soccer (e.g., mother, father, step-father, grand-parent, baby-sitter): Please put primary contact first.

Name Relationship Email Address Mobile phone number
 
1.2. Household Contact

Please list your families address and home telephone number. If there is another relevant address, list in the Additional Information section.

Street:
City
Zip Code:
Telephone:

 

2. Participant Information

 
2.1 First Child
First Name:
Last Name:
Nickname:
Gender: Female Male
Date of Birth:
School:
Grade:
Other Soccer Club Membership:

Any special concerns (e.g., health or social issues):

 
2.2 Second Child
First Name:
Last Name:
Nickname:
Gender: Female Male
Date of Birth:
School:
Grade:
Other Soccer Club Membership:

Any special concerns (e.g., health or social issues):

 
2.3 ThirdChild
First Name:
Last Name:
Nickname:
Gender: Female Male
Date of Birth:
School:
Grade:
Other Soccer Club Membership:

Any special concerns (e.g., health or social issues):

3. Additional Information

Please list any other issues we should be made aware of.

4. Privacy

Contact Soccer respects your privacy and would never release any information about your family without your permission. We must provide player information to Massachusetts Youth Soccer Association as part of our affiialiation and as an insurance requirement. We would also like to use photographs and/or video that might include your child/children in our promotional (e.g, web-site) and training materials. Please check one of the following:

You may use images that include my child/children in your promotional /training materials.

You may use images that include my child/children in your promotional /training materials, but please do not include his/her/their name.

Please do not use images that include my child/children in your promotional and training materials.

 

 

 

Copyright 2006 - Contact Soccer.- All Rights Reserved

 

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