HOME HOMEABOUTPROGRAMSTRYOUTSCOACHESCONTACTABOUTTRYOUTSCONTACTMORE THAN AGAMEBAMBINOFUTSAL ACADEMYDEVELOPING CREATIVE. CONFIDENT. INTELLIGENT PLAYERS.PLAY · LEARNGROW Website 1. PLAYER INFORMATION Player Full Name * Date of Birth * Age Gender Male Female Current Club, if any School Primary Position Dominant Foot Right Left Both 2. PARENT / GUARDIAN INFORMATION Parent / Guardian Name * Phone Number * Email Address * Address City State Zip 3. EMERGENCY CONTACT Emergency Contact Name * Relationship to Player Phone Number * 4. MEDICAL INFORMATION Allergies — food, medication, etc. Medical Conditions / Injuries Current Medications HOW DID YOU HEAR ABOUT BAMBINO FUTSAL ACADEMY? Facebook Instagram Friend / Family Coach Other: 5. TRYOUT GROUP (PLEASE SELECT) U12 BOYS U13 BOYS U14 BOYS 6. SHIRT SIZE (PLEASE SELECT ONE) YOUTH YXS — Youth XS YS — Youth S YM — Youth M YL — Youth L YXL — Youth XL ADULT AS — Adult S AM — Adult M AL — Adult L AXL — Adult XL 7. REGISTRATION & PAYMENT Tryout Fee $65 Payment Method Cash Check Venmo Cash App Zelle Amount Paid: $ Date Paid Received By 8. PARENT / GUARDIAN WAIVER & CONSENT I understand that participation in Bambino Futsal Academy tryouts involves physical activity and carries a risk of injury. I voluntarily allow my child to participate and release Bambino Futsal Academy, its coaches, staff, and volunteers from any liability for injuries that may occur during participation. I authorize emergency medical treatment if needed. I have read and agree to the Parent / Guardian Waiver and Consent. * PHOTO / VIDEO RELEASE Yes, I give permission for Bambino Futsal Academy to use photos and videos of my child for social media, marketing, and promotional purposes. No, I do not give permission. Parent / Guardian Electronic Signature * Printed Name * Date * OFFICE USE ONLY Registration Complete Payment Received Shirt Ordered Tryout Attended Player ID / Number Staff Initials Date Notes PRINT FORM SUBMIT REGISTRATION
