Registration Player Info Name of Player Age DOB (required) Team Player Email Parents Parents' Email Street Address City (required) ZIP State (required) Home Phone Work Phone Cell Phone Total amount: $160 Please read carefully the Important Notice& Waiver displayed on this page before signing this application. Hereby, I CONFIRM of reading and understanding in full, Important Notice and Waiver announced by FC Phoenix LLC. Parent/Guardian Info MotherFatherLegal guardian Name Phone City ZIP List any medical problems or prohibition of player please type in "x" or "none" if no info needed Person to notify in emergency Phone Doctor to notify in emergency Phone Health Insurance Company name Group/Policy number
