CHELMSFORD MEN'S SOCCER TRIAL
April 4th 2023
Name:
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Country Code
Phone Number
Parent / Guardian's Email
*
example@example.com
Parent's Phone Number
*
-
Country Code
Phone Number
Do you have any medical conditions or injuries we should be aware of?
*
Have you tested positive for COVID-19 or had symtpons in the past 7 days?
*
Confirm Preferred Playing Position
*
Goalkeeper
Right Back
Left Back
Centre Back
Right Midfield
Left Midfield
Centre Midfield
Striker
Would you like an individual player meeting following the game, where we can provide feedback on your performance and you can answer any questions you may have?
*
Yes
No
Undecided
Any additional information you think we should know:
Submit
Should be Empty: