Club Registration | FC Batavia Youth Soccer Club in Phoenix

Important Notice:

Please note that the following forms are to be completed only by individuals who have been extended an offer to joint FC Batavia for the season. Completing these forms alone do not represent a binding agreement between the club and a player unless an actual offer to play has been extended.

If seeking information on playing with FC Batavia please Contact Us

Next Steps:

Step 1: Club Registration
Provide all information about your player as well as necessary contact information for parents/guardians.

Step 2: Player Parent Agreement
Expectations for players and their families, rules, and means of communication.

Step 3: Financial Agreement
Indicate your understanding of all financial obligations that come with becoming a Batavian.

Registration should only take you a few minutes, but you may save your progress and return later if necessary.

Welcome to the club!

Save and Continue Later

Player Information
Player First Name*
Player Last Name*
Date of Birth*
Date Format: MM slash DD slash YYYY
Gender
Player School
At which level will your child play?*
- U7-U8
- U9-U10
- U11 - U13
- U14 - U15
- U16 - U19

Save and Continue Later

Player Information - Continued
Player Address*
Street City State Zip Country
Player Email
Player Home Phone
Player Cell Phone
Player Other Phone

Save and Continue Later

Emergency Contact Information
Emergency Contact Full Name*
Emergency Contact Phone Number*
Second Emergency Contact Full Name
Second Emergency Contact Phone Number

Save and Continue Later

Primary Contact
Primary First Name*
Primary Last Name*
Primary Email Address*
Primary Home Phone
Primary Cell Phone
Primary Other Phone
Would you like to add a Secondary Contact?
- Yes
- No

Save and Continue Later

Secondary Contact
Secondary First Name
Secondary Last Name
Secondary Email Address
Secondary Home Phone
Secondary Cell Phone
Secondary Work Phone

Save and Continue Later

Parent/Guardian Consent
I, the parent/legal guardian of the below-named player, a minor, agree that I and the player will abide by the rules and regulations of the USYSA, its affiliated organizations and its sponsors (“USYSA Parties”). In consideration of the player’s participation in the soccer programs and activities, including but not limited to athletic and social events of the USYSA Parties (“the Programs”) and FC Batavia, I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the USYSA Parties and FC Batavia, owners, operators, coaches / trainers, independent contractors, the owners and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents, independent contractors and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player’s participation in the Programs including, without limitation, player’s transportation to/from any Program, which transportation is hereby authorized. I further grant the USYSA Parties and all above mentioned parties the right to use the player’s name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player’s status as a participant in the Programs. I hereby grant FC Batavia permission to use names / photograph(s) / video of the below named player and myself in any and all publications and all other media, whether now known or hereafter existing, in perpetuity, and for other use by FC Batavia. I will make no monetary or other claim against FC Batavia for the use of information and photograph(s) / video.
Player Signature*
Player Name*
Player Sign Date*
Date Format: MM slash DD slash YYYY
Parents/Legal Guardian Signature*
Parents/Legal Guardian Name*
Parent Sign Date*
Date Format: MM slash DD slash YYYY

Save and Continue Later

Consent for Medical Treatment (Minor)
As the parent or legal guardian of the above named player, I hereby give consent for emergency Medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. I further request that in my absence the above named player be admitted to any hospital or medical facility for diagnosis/treatment. I authorize all diagnostic/treatment/operative/x-ray procedures of the above minor. I have not been given a guarantee as to the results of examination/treatment. I authorize disposal of any specimen or tissue taken from the above named player.
Player Medical Problems, Allergies, Medications, Other
Please list any known medical problems, allergies, medications, or otherwise. If none, please write "None".*
Terms Agreement
- I do not agree with FC Batavia's Parent/Guardian Consent or Consent for Medical Treatment (Minor)
- I agree and accept FC Batavia's Parent/Guardian Consent AND Consent for Medical Treatment (Minor)

Save and Continue Later

FC Batavia
Club Registration.

Important Notice:

Next Steps:

Player Information

Player Information - Continued

Emergency Contact Information

Primary Contact

Secondary Contact

Parent/Guardian Consent

Consent for Medical Treatment (Minor)

Player Medical Problems, Allergies, Medications, Other

Our Mission

Quicklinks

FC BataviaClub Registration.

Important Notice:

Next Steps:

Player Information

Player Information - Continued

Emergency Contact Information

Primary Contact

Secondary Contact

Parent/Guardian Consent

Consent for Medical Treatment (Minor)

Player Medical Problems, Allergies, Medications, Other

Our Mission

Quicklinks

FC Batavia
Club Registration.