Online Soccer Registration

Winter 2023-2024

The final schedule is dependent on the number of registrations for each division. A full and complete schedule for Session 1 will be emailed out on Tuesday, October 31, 2023.

PLAYER'S INFORMATION

Players Name(Required)
Player's Gender(Required)
Players Address(Required)
Shirt Size(Required)
Select the appropriate size shirt for the player. Shirts are cotton and tend to shrink a little after washing/drying.
Goal Keeping(Required)
Coaches will ask for goalkeeping volunteers each week. We think it's important to provide players an opportunity to play all positions. However, it would be helpful to know if a player WANTS to be a goalkeeper in an effort to avoid having 3 goalkeepers randomly placed on a single team, and no goalkeepers on another team. Checking this box does not mean the player will only be goalkeeping. We want aspiring goalkeepers to have time playing field positions as well.

Terms of Agreement

Club Name: Andro United
City: Leeds
State: ME
League Name: Androscoggin Youth Indoor Soccer

I hereby consent to the above-named club registering me with US Club Soccer. I understand that I may be registered to only one US Club Soccer member club at any time.

Note: it will not be necessary to complete this form again as long as the player is with this club, which will hold this form unless requested by US Club Soccer.

Do you agree to the terms of agreement?(Required)

PARENT OR GUARDIAN'S INFORMATION

Parent or Guardian's Full Name(Required)
Parent or Guardian's Address(Required)
Used for credit card billing purposes.
Additional Parent or Guardian's Full Name

EMERGENCY CONTACTS

Emergency Contact Person #1(Required)
Emergency Contact Person #2

MEDICAL & MEDIA INFORMATION

Physician's Name(Required)
Policy Holder's Name

Medical Agreement

I hereby give my consent to have an athletic trainer, coach, team manager, emergency medical technician, nurse, medical treatment facility, and/or doctor of medicine or dentistry or associated personnel provide the applicant/participant with medical assistance and/or treatment and agree to be financially responsible for the cost of such assistance and/or treatment. I understand treatment for injury will be based on information provided herein. I hereby authorize emergency transportation of the applicant/participant to a medical treatment facility should an individual listed above consider it to be warranted. I recognize the possibility of physical injury associated with soccer, and hereby release, discharge, and otherwise indemnify the club, US Club Soccer, their sponsors, the USSF and its affiliated organizations, and the employees and associated personnel of these organizations, against any claim by or on behalf of the soccer player named above as a result of that player’s participation in US Club Soccer programs and/or being transported to or from the same, which transportation I hereby authorize.

Do you consent to the Medical Agreement?(Required)

Media Agreement

I hereby give my consent and consent on behalf of my child to be photographed/filmed while participating in Andro United run events and to use such photographs/footage for any purpose, including promotional advertising.

Do you agree to the Media Agreement?(Required)
Please type your full name to be used as a digital signature.
MM slash DD slash YYYY
Relation to Player(Required)

IMPORTANT!!!

Please select the correct sessions you will be paying for below.

Session 1(Required)
Session 2(Required)
This field is for validation purposes and should be left unchanged.