Individual Youth/Adult Member Registration Form

Please fill out the form below to register a Youth Player or Adult Member with Massachusetts Youth Soccer. Please complete this form ONLY if you need to register a child or adult as an "individual," that is, if you are not affiliated with any club or town team in Massachusetts. This form is simply for registration with Massachusetts Youth Soccer. It does not sign you up to play with any soccer team!

An example of who would complete this form is a player who needs to become a member in order to sign up for a training course or a tournament. 

The following information refers to the REGISTRANT, that is, the player or adult registering with Massachusetts Youth Soccer.

Are you registering as a youth member
or as an adult member?
 *
Registrant Type *
Registering for Season *
Sign me up for *
I, The Parent/Guardian of the registrant, a minor, (or, if the registrant is an adult: I, the selfsame as the registrant) agree that I and the registrant will abide by the rules of Massachusetts Youth Soccer, and US Youth Soccer, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and it consideration for the Massachusetts Youth Soccer/US Youth Soccer accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify the Massachusetts Youth Soccer/US Youth Soccer, its affiliated organizations and sponsors, their employees and associated personnel, including owners of fields and facilities utilized for the Programs, against any claim by or on the behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize. *
As Parent/Legal Guardian of (or selfsame as) the above named registrant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well being of (me or) my dependent. *
I agree to pay $17.00 in order to register as an individual with Massachusetts Youth Soccer. I understand that if payment is not made, I will not be registered. *