IER Pateadores are looking for players of all age groups and levels of play.

Question Title

* 1. Player Name

Question Title

* 2. Boy or Girl

Question Title

* 3. Year Born

Question Title

* 4. In what month were you born?

Question Title

* 5. What club do you currently play for?

Question Title

* 6. What position do you play?

Question Title

* 7. Parent Name

Question Title

* 8. Home address, city and zip code.

Question Title

* 9. Phone Number

Question Title

* 10. Email (We will update you on tryout status via this primary email)

Question Title

* 11. Liability Release and Consent to Treat

I, the Parent/Guardian of the player named hereon acknowledges that participation in the sport of soccer, as in any sport may result in injury. The undersigned Parent/Guardian therefore releases the Pateadores Soccer Club, its teams, agents, officers, coaches, players, from all liability and responsibility for any claim, damage, or legal action on behalf of the player or players parents, heirs, or personal representatives, arising from any injury the player may sustain while participating in soccer or related activities, including transportation.

As the Parent/Guardian of the above named player, I give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

T