NORTHERN ILLINOIS SOCCER LEAGUE

PLAYER APPLICATION
NORTHERN ILLINOIS SOCCER LEAGUE
545 Consumers Avenue, Palatine, IL 60074 Telephone #847-398-4545 ext 106-108 Fax # 847-398-4593

30 YEARS OF EXPERIENCE IN ADMINISTRATION & DEVELOPMENT OF COMPETITIVE YOUTH SOCCER WE PROVIDE THE BEST SERVICE TO THE BEST ORGANIZATIONS
* PLAYER REGISTRATION FORM *
*

NEW PLAYERRETURNING PLAYER
CLUB NAME:*
AGE DIVISION:*
TEAM NAME:*
GENDER OF TEAM:*

MALEFEMALE
PLAYERS REGISTRATION ID #:
PLAYERS FIRST NAME:*
MIDDLE INITIAL:
PLAYERS LAST NAME:*
PLAYERS ADDRESS:*
CITY:*
STATE:*
ZIP:*
PLAYERS PHONE NUMBER:*
BIRTHDATE:*

MonthDayYear
Date
Gender*

MaleFemale
PLAYERS EMAIL ADDRESS:*
example@example.com
FATHER
NAME*
Phone Number*

Area CodePhone Number
EMAIL:*
example@example.com
MOTHER
NAME*
Phone Number*

Area CodePhone Number
Email*
example@example.com
*

PROOF OF AGE PROVIDED
*

Birth CertificatePassport
*

Browse Files

Cancelof
*

THIS PLAYER IS NOT REGISTERED WITH ANY OTHER US CLUB SOCCER REGISTERED TEAM / CLUB THIS PLAYING YEAR
I UNDERSTAND THAT BY SIGNING THIS DOCUMENT I (OR MY CHILD) IS OBLIGATED TO PLAY FOR ONLY THIS TEAM UNTIL AN APPLICABLE RELEASE FOR ANOTHER TEAM OR CLUB IS OBTAINED
Players Signature*
Date*

MonthDayYear
Date
PARENTS SIGNATURE:*
Date*

MonthDayYear
Date
COACHES SIGNATURE:
Date

MonthDayYear
Date
www.northernillinoissoccerleague.com / www.NISL.info
Should be Empty: