Youth Soccer Registration

Player First Name*

Player Date of Birth

Player Last Name*

Interest in playing goalie

Comments / Concerns / Medical Information (e.g. allergies)

Parent 1 First Name

Parent 1 Phone Number*

Parent 1 Last Name

Parent 1 Email*

Parent 2 First Name

Parent 2 Phone Number

Parent 2 Last Name

Parent 2 Email

At ESRA we strive to create equally matched teams, however we also understand recreational soccer is also about playing with friends. We will try our best to match friends while creating balanced teams.

Parent coaches are an indispensable component of our programs. At ESRA we recognize and value those parents who volunteer to coach by offering a refund of soccer registration fees upon return of the equipment at the end of the season. Ideally each team will have a Head Coach and Assistant Coach. Please consider signing up for one of these roles!

I am willing to volunteer for the following roles (check all that apply):

Head Coach

Assistant Coach

By submitting this registration, you acknowledge that there are certain risks of damages and injuries, including death, inherent in the practice and play of all sports, as well as in travelling and other related activities incidental to your child’s participation. You are willing to accept these risks on behalf of your child. These risks include, but are not limited to, hazards associated with weather conditions, travel, playing conditions, equipment and other participants.

I acknowledge and accept the aforementioned risks.

I accept terms & conditions

Thanks for submitting!