Fall 2026 Registration
Fall season games are scheduled to begin weekend of September 12th. Practices will be twice a week with schedule to be determined by the team coach. Please complete the form and submit. A Square invoice will be sent to the provided email address below within 48 hours of submitting form. If you have any questions please contact us via email DeelynnTorres@gmail.com.
Players Name
*
First Name
Last Name
Players Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email
*
example@example.com
Gender
*
Male
Female
Parent's Name
*
First Name
Last Name
Parent's Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent's Email
example@example.com
School Currently Attending
*
School Name
Grade Level
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
Name
Phone Number
Previous Club/Team
*
Jersey Size
*
Please Select
Youth XSmall
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Shorts Size
Please Select
Youth XSmall
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Medical Issues
Please list any medical issues that Express staff should be aware of.
I, the parent/guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of theUSYSA, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated withsoccer and in consideration for the USYSA, accepting the registrant for its soccer programs and activities (the"Programs"), I hereby release, discharge and/or otherwise indemnify the USYSA, its affiliated organizations andsponsors, their employees and associated personnel, including the owners of fields and facilities utilized forthe Programs, against any claim by or on behalf of the registrant as a result of the registrant's participation inthe Programs and/or being transported to or from the same, which transportation I hereby authorize. Inaddition, I authorize the use and reproduction of any/all photographs which depict Club activities.CONSENT FOR MEDICAL TREATMENT (MINOR)As the parent or legal guardian of the above-named player, I hereby give consent for emergency medical careprescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given underwhatever conditions are necessary to preserve life, limb, or well being of my dependant.*
*
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