Skip to content
H-Town Soccer Academy Tryout Registration Form
Registration Form
Please be sure all information is accurate. This is for Tryouts in December 2025 at Moody Park, Milby Park, and Alief Park
OK
*
1.
Site
(Required.)
Milby Park; 2001 Central St. Houston, TX 77017 (South East) December 8-11th
Alief Community Park; 11903 Bellaire Blvd. Houston TX 77072 (West) December 8th -11th
Moody Park; 3725 Fulton St, Houston, TX 77009 (Central/North) December 15th - 18th
*
2.
New to H-Town?/Nuevo a H-Town?
(Required.)
No (Please Put Your Jersey Number Below)/No(Favor de poner su numero de camisa abajo)
Yes
Jersey Number (Only RETURNING players/Solamente jugadores REGRESANDO)
*
3.
Player First Name/Nombre de Jugador
(Required.)
*
4.
Player Last Name/Apellido de Jugador
(Required.)
*
5.
Date of Birth/Fecha de Nacimiento (MM/DD/YYYY)
(Required.)
6.
Which position do you play?/Cual posicion juegas?
7.
What is the highest level you have played?/Que es el nivel mas alto que haz jugado
*
8.
Gender/Sexo
(Required.)
Male
Female
*
9.
Ethnicity/Ethnica
(Required.)
African-American/Afroamericano
American-Indian/Native Alaskan/Indígena-Americano/Indígena de Alaska
Asian/Asiático
Caucasian/Caucásico
Haitian/Haitiano
Hispanic/Latin/Hispano/Latino
Pacific Islander/Isleño Pacifico
Other/Otro (please specify/por favor especifica)
*
10.
Parent/Guardian Information
Información de Padre(s)
(Required.)
Name/Nombre
Address/Dirección
City/Ciudad
State/Estado
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP Code/
Código Postal
Email Address/
Correo Electrónico
Phone Number/
Teléfono
*
11.
Relationship to Child
Relación al niño(a)
(Required.)
Parent/Padre
Legal Guardian/Tutor Legal
Foster Parent/Padre Adoptivo
Grandparent/Abuelitos
Sibling/Hermano o Hermana
Other Relative/Otro Pariente
*
12.
Emergency Contact (Other than Parent/Guardian)
Contacto en caso de Emergencia (Otro que no sea Padre/Tutor Legal)
(Required.)
Name/Nombre
Relationship to Child/
Relación al niño(a)
Phone/Teléfono
*
13.
I, the undersigned, understand that participation in the Houston Parks and Recreation Department's (HPARD) H-Town Soccer Academy involves certain inherent risks of injury, despite all safety precautions taken by the HPARD. Therefore, as
parent
and/or guardian, I will assume all risks, injury or illness, for my child(ren) that may occur during the participation in any activities or use of facilities associated with the H-Town Soccer Academy. In the event that my child(ren) need medical treatment due to accident or injury or natural causes while registered and participating in the H-Town Soccer Academy program, I authorize the HPARD staff and operators to take whatever action is necessary to care for my child(ren). I hereby give permission for the HPARD staff to use their best judgment in arranging for my child(ren)’s emergency medical treatment in addition to contacting me to the best of their ability. I certify that my child(ren) is/are fully covered by medical insurance and that I am fully responsible for all costs incurred due to medical or dental treatment as deemed necessary by the HPARD staff and operators.
By signing this form, I acknowledge that I am aware of the potential risks of
participation
in any activities or use of facilities associated with the H-Town Soccer Academy program, and in no way hold the HPARD, its respective parent, its subsidiaries or affiliates, or their respective management, agents, employees, directors, officers, sponsoring agencies, volunteers or the facility or its operators, coaches, officials, or advertisers, (individually and collectively, the "released parties"), liable for any injury that my child(ren) may sustain. I, FOR MYSELF, MY SPOUSE AND MY CHILD(REN), DO FURTHER RELEASE, ABSOLVE, INDEMNIFY, AND HOLD THE RELEASED PARTIES HARMLESS AGAINST ANY CLAIMS OF INJURY OR DEATH TO MY CHILD(REN) IN CONNECTION WITH ANY AND ALL OF THE ACTIVITIES MENTIONED.
I HAVE READ, AND I UNDERSTAND, AND I VOLUNTARILY SIGN THIS MEDICAL RELEASE/WAIVER/INDEMNITY AGREEMENT.
(Required.)
Agree
*
14.
Parent/Legal Guardian Signature
Firma de Padre
(Required.)
Current Progress,
0 of 14 answered