Try-out Info and Application

EISA is a newly formed soccer club with membership in the Iowa Soccer Association.  We are working to develop and promote youth soccer in the surrounding communities.  EISA is a club for developing soccer players and teams with focus on fundamental skill development, which will prepare our players for the demands of competitive league, tournament and high school competition.  EISA provides access to coaching and player instruction.  For more information, check out our website at: http://www.eisasoccer.com

 

EISA will be rostering boys and girls teams from ages 8 to 17 to play in the Illowa soccer league this fall (2010) as well as tournaments.  EISA uses the BSA soccer complex in Mt. Joy for league home games.  Team practices are held in the community of the team/coaches.  Try-outs will be held at Westbrook Park in DeWitt, Iowa.  Please arrive by 5:30PM for registration/check-in.  Try-outs are from 6:00PM-7:30PM on Monday, May 17th and Tuesday, May 18th.  Attendance of both days is not required, however, we recommend attending both days to improve our evaluation of your child.  If you already have a team formed from your community, we can roster it.  If you are looking for a team for your child to play on, we can help try to place him/her.

 

 

Player Name:                                                                 Gender: M / F

Contact Phone:                                 Contact E-mail:                                              

Date of Birth (M/D/Y):                               Years of Experience:                          

Current Club Team or Team Forming:                                                                  

City:                                                               School:                                     

Allergies:                                                 

Medical Conditions:                                                                                                

 

MINOR RELEASE

 

I, THE MINOR'S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF SOCCER ACTIVITIES  AND THE MINOR'S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY.  I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE'S (EISA, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessers of premises on which the Activity takes place) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR'S ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE "RELEASEES" OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I, THE MINOR, OR ANYONE ON THE MINOR'S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

 

PRINTED NAME OF PARENT/GUARDIAN:                                                                                                                                                                             

 

ADDRESS:                                                                                                                                                                                                                              

                                  (Street)                                                                         (City)                                                           (State)                       (Zip)

PHONE:                                                                        

 

PARENT/GUARDIAN SIGNATURE:                                                                                                                                    

 

DATE:                                                                           

 

This Box For Club Use: