Indoor Outdoor Soccer! FIAO Soccer Registration Player InformationName* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Medical Conditions (if any)*Family Group Insurance (if any)*Has player ever played Soccer before with FIAO or other organization?*YesNoWhat team have you played with?*Coach's Name*Type of Program (Select all that apply)* Indoor Outdoor Player Uniform Size*YSYMYLASAMALParent InformationAre you FIAO member?*YesNoWould you like to receive membership information?*YesNoName* First Last Email Address* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work PhoneWould you like to volunteer?*YesNo, I can'tFIAO’s Soccer Tournament Relies Greatly on Parental Involvement. Select "Yes" to Volunteer In One of the Areas ListedPlease Check One*CoachRefT.P.A.C.SponsorEmergency Contact Name* First Last Emergency Contact Phone*Relationship*Emergency Contact Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parental ConsentConsent* I permit my child, named above, to participate in the FIAO’s Soccer Program & Tournament and agree to the following: I understand that I will not hold FIAO or the coaches, managers and Board of Directors legally responsible for any accidents that might occur during practice, actual soccer games and transportation. Secondary insurance coverage will be provided by FIAO in the event that such coverage is necessary to cover medical expenses arising from any injury during participation.PLEASE SUBMIT A COPY OF CHILD’S BIRTH CERTIFICATE AND A PHOTO FOR OUR RECORDS* Drop files here or Accepted file types: jpg, jpeg, png, pdf, bmp. Price Price: $125.00 Price Price: $250.00 Total $0.00
