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Tryout Registration



    Division Ages
Please use the table below to verify your age group BEFORE completing the registration form.

U7 - Born between Aug 1, 2000 and July 31, 2001
U8 - Born between Aug 1, 1999 and July 31, 2000
U9 - Born between Aug 1, 1998 and July 31, 1999
U10 - Born between Aug 1, 1997 and July 31, 1998
U11 - Born between Aug 1, 1996 and July 31, 1997
U12 - Born between Aug 1, 1995 and July 31, 1996
U13 - Born between Aug 1, 1994 and July 31, 1995
U14 - Born between Aug 1, 1993 and July 31, 1994
U15 - Born between Aug 1, 1992 and July 31, 1993
U16 - Born between Aug 1, 1991 and July 31, 1992
U17 - Born between Aug 1, 1990 and July 31, 1991
U18 - Born between Aug 1, 1989 and July 31, 1990



Read these directions completely BEFORE filling out the form. It will save you time and frustration.

Please complete all *Required fields on this form. You must SUBMIT this web-based form by clicking on the "Submit Registration" button below to complete your registration. DO NOT PRINT THIS FORM!

When you submit this web-based form, you will receive an email. THE EMAIL IS YOUR REGISTRATION FORM THAT YOU SHOULD BRING TO TRY-OUTS.
Player Information
*Age Group (Select the age group for the 2007/08 season)
*Date of Birth // (Ex: 01/23/1991)
*Name

First Name
Last Name
*Address
*City/State/Zip
*YOUR Email Address:
*Home Phone  
*Wireless Phone  
(If you do not have a wireless phone/pager, enter all 0. You can not leave this field blank.)
*School District
*School Attending in
2007/2008
*Most Recent Outdoor Team
*Positions You Played
(Check all that apply, you must enter at least one.)
Forward
Midfielder
Defender
Goakeeper
Parent/Guardian Information
(You must include information on at least one parent/guardian)
*Parent One
*Name

First Name
Last Name
*Phone 1  
*Phone 2  
*Email Address
(This MUST be a different address than yours. If your parent does not have an email address, enter none@none.com)
Parent Two
Name

First Name
Last Name
Phone 1  
Phone 2  
Email Address
Comments
Liability Waiver and Statement of Understanding
Please check this box to verify your application is complete and accurate (this form will NOT be accepted without verification). Parents will be asked to sign the email with the following waiver:

Parents approval and medical release: recognizing the possibility of injury, both physical and mental, associated with soccer and soccer try-out procedures, and in consideration for the FC Peoria. and its affiliates accepting the registrant for its soccer try-out program and associated activities I hereby release, discharge and otherwise indemnify the FC Peoria, its affiliated organizations, and sponsors, their employees and associated personnel, including the owners of the fields and facilities used for the programs against any claim by or on behalf of the registrant as a result of the registrants participation in the programs and/or being transported to and from the same, which transportation I hereby authorize.
 

Please click ONCE ONLY on the submit button above. Sometimes, it take a few seconds for the form to be processed. Thank you. Be sure you checked the verification box above before attemtping to submit this form.




FC Peoria
12026 N. Old Galena Rd. PO Box 294 Mossville, IL 61552
Phone 309-579-3535 Fax 309-579-3707