Vermilion County Soccer Club

Traveling Teams Tryout Application

Spring 2009

Please Select one of the following: Youth High School

Date

Player's Information:

First Name: Last Name:

Player's Age on August 1, 2008: Player's DOB (MM/DD/YY):

Street Address: City:

State: Zip:

Player's Contact Information:

Player's Cell Number

Player's e-mail Address:

Parent(s) Guardian First Name Parent(s) Guardian Last Name:

Home Phone Number: Email Address:

Cell Number 1: Cell Number 2

Medical Concerns:

Email the Form as an attachmnet