form test - FC Batavia Youth Soccer Club in Phoenix

Player Information

Player First Name*

Player Last Name*

Gender*

Current Age*

Birth Month*

Birth Day*

Birth Year*

School*

Grade*

Soccer Experience*

Jersey Size*

How'd you hear about our Grassroots program?*

Please clarify "other"*

Primary Contact

The primary contact will receive club communication. Please ensure the email provided is active and correctly entered so that you can receive important club announcements and information.

First Name*

Last Name*

Email Address*

Email * Confirm Email *

Phone*

Address*

Street Address * Address Line 2 City State / Province / Region ZIP / Postal Code

Would you like to volunteer? Check all that apply.

Head Coach

Assistant Coach

Note: All coaches will be subject to a background check and must complete additional trainings.

Shirt/Jersey Size*

Secondary Contact (optional)

First Name

Last Name

Email Address

Phone

Would you like to volunteer? Check all that apply.

Head Coach

Assistant Coach

Note: All coaches will be subject to a background check and must complete additional trainings.

Shirt/Jersey Size*

Required Consent and Waivers

Please review and consent to the following policies prior to registration.

Hate Speech Consent*

I AGREE to the Hate Speech Policy

Hate Speech Consent*

I AGREE to the Parent Code of Conduct Policy

Hate Speech Consent*

I AGREE to the Player Code of Conduct Policy

View our Social Media Waiver

Hate Speech Consent*

I AGREE to the FC Batavia Social Media Waiver

I DO NOT AGREE to the FC Batavia Social Media Waiver

Additional Comments

(Optional)

Recap & Payment

8 game Season
Games played Saturday mornings @ Greenway Middle School starting September 28 thru November 8
Boys and Girls Ages 6-14 (8th grade)
Volunteer Coaches – Following orientation, Coaches are under the guidance of Coach Andreas Papastakos. Parents who may be interested in coaching should contact Coach Andreas at andreas.papakostas@gmail.com.
Support from Grassroots Director and FC Batavia High School players

FC Batavia Grassroots Program Registration

Price:

Discount Code

Total Fees Due

Secure Credit Card Payment*

Card Details

Cardholder Name

Test – Grassroots Program Registration

Player Information

Primary Contact

Secondary Contact (optional)

Required Consent and Waivers

Additional Comments

Recap & Payment

Our Mission