Elite Development Player League
Player Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Are you registering for the Fall 2025 EDPL Session?
*
Yes
No
Player Shirt Size?
*
Youth Large
Youth Meduim
Youth Small
Youth Extra-Small
Other
Player Short Size?
*
Youth Large
Youth Meduim
Youth Small
Youth Extra-Small
Other
Did you participate in the last EDPL session?
*
Yes
No
Preferred Payment Method (both methods come with installment plans if desired and actual payments do not start until September 3rd)
*
$349 for the Fall Session (Winter session price will go to $449)
$1,396 for the full Club Season locking you in at the $349 per session price
You are registering for the EDPL, but would you like to be updated about individual and small group training opportunities through our Empire State Skills Academy?
*
Yes
No thank you
Maybe
Parent/Guardian Contact
Parent Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
Name
*
First Name
Last Name
Relationship to Player
*
Phone Number
*
Please enter a valid phone number.
Medical Information
Known Allergies
*
Medical Conditions
*
Medications
*
Physician Name & Phone (optional)
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Player Media Release
I understand that photos or videos of my child may be taken during the course of activities. By signing this form, I grant permission for Empire State FC to use these images for promotional purposes such as social media, website content, and print materials. If I do not wish for my child’s image to be used, I understand that I must notify Empire State FC in writing prior to participation.
I agree to the media release terms (Initials):
*
Child’s Liability Waiver
I acknowledge that participation in soccer includes a risk of injury. I hereby release, indemnify, and hold harmless Empire State FC, its directors, coaches, volunteers, and facility owners from any and all claims, liability, or damages arising from my child's participation in with Empire State FC. I confirm my child is in good health and able to participate in physical activity.
I agree to the liability waiver terms (Initials):
*
Emergency Medical Consent
In the event of an emergency where I cannot be reached, I authorize Empire State FC staff to obtain necessary emergency medical care for my child.
I agree to the emergency medical care (Initials):
*
Parent or Guardian Acknowledgment
Signature
*
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Continue
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