Soccer Registration

Soccer Registration Form  

2024 Player Registration Fee is $25 per player 

Player Information 

Last Name ​______________________________​ First Name ​_____________________________​ Address​_______________________________________________________________________​City​__________________________________​State​____________________​Zipcode​__________​Phone Number​(____)_____-_______ ​Date of Birth ​_________________​​☐​ Male  ​☐​Female         T-shirt size: Small​☐​ Med​☐​ Large​☐​ Any Known Allergies​: _______________________________​ Current school/college or club affiliation:​ ____________________________________________​ ​______________________________________________________________________________​ 

Parent or Guardian Information 

Father's Name ​___________________________________​ Alternate Phone ​(____)_____-______​ Mother's Name ​_________________________________​ Alternate Phone ​(____)______-______​ List any medical problems or prohibition player has ​____________________________________​ Person to notify in emergency ​______________________________​ Phone (​____)_____-______​ Doctor to notify in Emergency ​_______________________________​ Phone (​____)_____-_____​ 

Important 

I, or the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of Hildale City, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for Hildale City accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge including the owners of fields and facilities utilized for the Programs, against any claims by or on behalf of the registrant as a result of the registrant’s participation in the programs and/or being transported to or from the same, which transportation I hereby authorize. 

Player Signature ​___________________________________________​ Date ​_____-_____-_____​ Parent or Guardian Signature ​_________________________________​ Date ​_____-_____-_____​ 

Helping Hildale’s Youth Hit Their Goals 

320 E Newel Ave    PO Box 840490    Hildale, UT 84784-0490 

Tel: (435)-874-2323   Fax: 435.874.2603 

Website: Hildalecity.com