3/4th Grade Travel/Academy Evaluation Registration

Your child's first name

Your child's last name

Are you trying out for the Revolution Academy Program?

Yes, I am trying out for Academy

No, I am being evaluated for the Travel program only

Answering yes to this question means you would like to be assessed for the Revolution Academy program, considered for the Academy roster and, where appropriate, recieve an offer to participate in this program for the 2022/23 season following the evaluation process.

Your child's grade (they will be in Fall 2022 Season)

Gender

Male

Female

Would your child like to play as a goalkeeper?

Yes, my child would like to be considered as a dedicated goalkeeper

My child does not want to be a dedicated goalkeeper but would like to play as a part time goalkeeper from time to time

Who was your child's coach last season?

Used for all communication, INCLUDING notification of tryout results

Emergency Telephone

Please read and accept this waiver

I, parent/legal guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of the Hopkinton Youth Soccer, their affiliated organizations and sponsors (‘Club’). I desire to have the registrant participate in the Soccer (‘Sport’) programs and activities, including indoor/outdoor play, practices, clinics and games ('Programs') offered by said ‘Club’. Recognizing the possibility of physical injury associated with said ‘Sport’ and the registrants participation in the Programs, and in consideration for the ‘Club’ accepting the registrant for participation in the Programs, on behalf of myself and the registrant, I hereby release, discharge, and/or otherwise indemnify the Club, their respective officers, directors, coaches, committees, employees and associated personnel, including the owners of the fields and facilities utilized for the Programs, of and from any claim, demand, action, cause of action, suit or liability arising as a result of the registrant's participation in the Programs, including the transport of the registrant to or from the Programs, which transportation I hereby authorize.

Please read and accept this waiver:

As parent or legal guardian of the minor named on this form, I hereby give my consent to seek, obtain and provide emergency medical/dental treatment in case of injury that occurs while participating in Hopkinton Youth Soccer-related activities. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependent.