Academy Team Tryout Form

Please submit the following form to pre-register for all City Islanders Academy team tryouts. Thank You.

Player's Full Name	*
Player's Age Group	*	U9 Boys U10 Boys U11 Boys U12 Boys U13 Boys U14 Boys U15 Boys U16 Boys U17 Boys U23 Mens Super 20 U9 Girls U10 Girls U11 Girls U12 Girls U13 Girls U14 Girls U15 Girls U23 Womens
Player's Birthdate	*
Parent/Guardian Name	*
Phone	*
Email Address	*
Address	*
City	*
State	*
Zip	*
Club Team	*
Travel Team?	*
Club Coach's Name
Position	*	Goalkeeper Defender Midfielder Forward
Years Playing?
H.S./College Experience (U16-Super 20)
Payment Options
COMMENTS?
Liability Waiver		By submitting form you agree to accept the CIA Assumption of Risk and Liability of Waiver Rules