Premier Soccer Academy Under _____ Boys Girls Team Coach ________________________________
Date of Birth: _____________________ Mother's Birth-date ____________________
Player’s Full Name:______________________________________________________________________
Name Called _____________________________ Home Phone: _________________________________
Father’s name: ____________________________ Work Phone: __________________________________
Father’s home number if different from player’s Home: __________________________________________
Mother’s name: ___________________________ Work Phone: ___________________________________
Mother’s home number if different from player’s Home: __________________________________________
Family E-mail: ___________________________________________________________________________
Address: ________________________________________________________________________________
City: ________________________ St: ______ Zip: _________
I, (we) the parent/legal guardian of the above player, a minor, agree that the player and I (we) will abide
by the rules of Premier Soccer Academy, Tennessee Premier Soccer Association, Southeastern District,
Tennessee State Soccer Association and USYSA, its affiliated organizations and sponsors. Recognizing
the possibility of physical injury associated with soccer and in consideration for Premier Soccer
Academy, Tennessee Premier Soccer Association, Southeastern District, Tennessee State Soccer
Association and USYSA accepting the above named registrant for its soccer programs and activities, I
hereby agree to assume the risk of and hold harmless, release, discharge and/or other wise indemnify
the Premier Soccer Academy, Tennessee Premier Soccer Association, Southeastern District, Tennessee
State Soccer Association and USYSA, their affiliated organizations and sponsors, their employees and
associated personnel, including the owners of the fields and facilities utilized for the programs, against
any claim by or on behalf of the registrant, as a result of their participation in the programs and/or being
transported to or from the same. I also authorize transportation convenient or necessary to and from
any athletic event or social event connected with this club.
Parent /legal guardian Signature________________________________________Date:___________________
Player Signature _____________________________________________________________________
Coaches Signature_____________________________________________Date:______________
By signing this form I give Premier Soccer Academy, Tennessee Premier Soccer Association, permission
to register my son/daughter to play for the above team for the TS current seasonal year(Aug-July) *** I
understand that as a player/parent that I do not have to commit to any association, team, or coach during
the open period and I can not be punished by trying out for any other association, team, or coach during
this period ***
Date of Birth: _____________________ Mother's Birth-date ____________________
Player’s Full Name:______________________________________________________________________
Name Called _____________________________ Home Phone: _________________________________
Father’s name: ____________________________ Work Phone: __________________________________
Father’s home number if different from player’s Home: __________________________________________
Mother’s name: ___________________________ Work Phone: ___________________________________
Mother’s home number if different from player’s Home: __________________________________________
Family E-mail: ___________________________________________________________________________
Address: ________________________________________________________________________________
City: ________________________ St: ______ Zip: _________
I, (we) the parent/legal guardian of the above player, a minor, agree that the player and I (we) will abide
by the rules of Premier Soccer Academy, Tennessee Premier Soccer Association, Southeastern District,
Tennessee State Soccer Association and USYSA, its affiliated organizations and sponsors. Recognizing
the possibility of physical injury associated with soccer and in consideration for Premier Soccer
Academy, Tennessee Premier Soccer Association, Southeastern District, Tennessee State Soccer
Association and USYSA accepting the above named registrant for its soccer programs and activities, I
hereby agree to assume the risk of and hold harmless, release, discharge and/or other wise indemnify
the Premier Soccer Academy, Tennessee Premier Soccer Association, Southeastern District, Tennessee
State Soccer Association and USYSA, their affiliated organizations and sponsors, their employees and
associated personnel, including the owners of the fields and facilities utilized for the programs, against
any claim by or on behalf of the registrant, as a result of their participation in the programs and/or being
transported to or from the same. I also authorize transportation convenient or necessary to and from
any athletic event or social event connected with this club.
Parent /legal guardian Signature________________________________________Date:___________________
Player Signature _____________________________________________________________________
Coaches Signature_____________________________________________Date:______________
By signing this form I give Premier Soccer Academy, Tennessee Premier Soccer Association, permission
to register my son/daughter to play for the above team for the TS current seasonal year(Aug-July) *** I
understand that as a player/parent that I do not have to commit to any association, team, or coach during
the open period and I can not be punished by trying out for any other association, team, or coach during
this period ***
| Your player has been offered a place on Premier Soccer Academy To accept this offer, complete this form, and return it to the registrar. Permission To Roster Form ALL BLANKS MUST BE FILLED OUT COMPLETELY |
Player Commitment Letter
TSSA Registration Fees: U9-U10-U11 = $20 Yearly
U12 & Over = $30 Yearly
(Payment made to PSA and submitted with form)
U12 & Over = $30 Yearly
(Payment made to PSA and submitted with form)
