Player's Birth Date *

MM

DD

YYYY

Parent/Guardian Cell Phone *

(###)

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2nd Parent/Guardian Cell Phone

(###)

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Concussion Statement *

I have read, understood, consent to and will abide by the Student-athlete & Parent/Legal Guardian Concussion Statement..

Financial Commitment *

I have read, understood, consent to and will abide by the Player’s Club Dues Financial Commitment.

Non-Resident City Tax *

I have read, understood, consent to and will pay the Non-Resident City Tax fee.

I am a Bartlett City Resident.

Venmo *

The exact amount MUST be paid to Bartlett Soccer Club. If you choose to “protect” your payment (move the slider), Venmo will divert part of your payment leaving you with a balance owed to BYSA.

I have read, understood, consent to and will abide by the Venmo exact payment agreement.

Parental Expectations and Guidelines *

I have read, understood, consent to and will abide by the Parental Expectations and Guidelines.

Release of Liability *

I have read, understood and will abide by the Release of Liability for Minor Participants statement.

Photo Release *

I have read, understood, consent to and will abide by the Minor Participants Photo Release Agreement.

Permission to Roster *

I have read, understood, consent to and will abide by the Player Commitment Letter and Permission to Roster.