MV Soccer Booster Club

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2026 MV Cub Soccer (Fall Middle School)

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Gender:

* Shirt size:

Allergies / Other Information:

PARENT/GUARDIAN #1

* First name:

* Last name:

* Parent, Guardian or Adult E-mail:

* Cell Phone:

PARENT/GUARDIAN #2

First name:

Last name:

Email:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact Name (Someone other than a parent):

* Phone:

Relationship to Player:

WAIVER INFORMATION

We/I represent that my child is physically fit and suffers from no health issue which would prevent him/her from participating in this athletic program. We/I release and hold harmless Mt. Vernon Soccer Booster Club, Metropolitan School District of Mt. Vernon, Kickers SAY, employees and volunteer personnel from any and all liability loss, damage, or injury which may result or occur during the course of this athletic program.

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2026 MV Cub Soccer (Fall Middle School)