Registration – Fall Youth Program | San Jose Fly Field Hockey

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Registration - Fall Youth Program

"*" indicates required fields

Athlete's Name*

First Last

Athlete's School*

Grade (fall of 2023)*

Playing Experience*

Birth Date*

Played with Fly before?*

If you are new to Fly, you will need to turn in a Liability Waiver (PDF available on the Player Registration page).

USA Field Hockey Member #*

USA Field Hockey membership is REQUIRED in order to play with Fly. Visit the USA Field Hockey website (https://usafieldhockey.webpoint.us/wp/Memberships/Join.wp) for membership information.

T-Shirt/Pinnie Size*

Parent First Name*

Parents' Last Name*

Address*

Street Address City State ZIP Code

Home Phone*

Contact Email*

Enter Email Confirm Email

Emergency Contact Name*

Relationship to Player*

Emergency Phone Number*

Questions or Commments

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