Battle Ground Soccer Registration 2019 Battle Ground Soccer RegistrationInstructions Please remember, that your registration and individual slot is not 100% reserved until we receive your Pay Pal Payment. Payment is due in FULL after submitting this form.Player / Coach InformationYour preferred position: *Check off your preferred positionsGoalieDefenseMidfieldAttackI am a Coach who will Coach a TeamName: *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPlayers Date of Birth *Age Groups (Recreation): *All individual registrations will be put in the recreation division.8U Boys (Age 6,7,8)10U Boys (Ages 9,10)13U Boys (age 11,12,13)Boys 16U (age 14,15,16)8U Girls (Age 6,7,8)10U Girls (Ages 9,10)12U Girls (Ages 11,12)15U Girls ( Age (13,14,15)Coach Preference: If you have a preference of a particular coach, please input it here.Contact Information:Parent/Guardian Name: *Primary Contact Cell # *Primary Contact Email: *Secondary Contact Name: Secondary Contact Cell # Secondary Contact Email: Special Instructions: I certify As the undersigned Parent/Legal Guardian of the Player named above I understand that my child will not be covered by any program insurance, and agree that I will not hold the team, the club, the coach, any instructors or Harford Sports Performance Center responsible for injuries received while participating in the above tryout and/or program.Digital Signature *YesNoDate Signed: * VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: