Winter Futsal Registration

Please Note:
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Select One*
- Guest Player - part-time player
Team Name*
Player Name*
First Last
Futsal/Soccer Level of Play*
Player's Birthdate*
MM slash DD slash YYYY
Division*
- u10
- u12
- u14
- High School
- Adult
Gender*
- Boys
- Girls
- Coed (HS & Adult Only)
Contact Name*
First Last
Contact Phone*
Contact Email*
Schedule Conflicts
**Schedule conflicts are not guaranteed; however, we will do our absolute best to make sure to accommodate as many requests as possible. **
Liability Waiver and Medical Release
I hereby agree to indemnify and hold harmless Center Circle LLC, Bert Ferguson Park (Memphis Park & Rec), Faith Lutheran Church, Collierville, TN and/or any officers, partners, members, directors, coaches, employees, servants, agents, licensees and assigns of any of the foregoing, from and against any and all suits, awards, claims, damages, liabilities, costs and expenses (including reasonable attorney fees and related costs) arising out of injury or damages to myself or family members, in connection with my or their participation in any Center Circle LLC program, league, tournament, open play or other activity. I also recognize my team is fit for this type of physical activity. Each team acknowledges that futsal/soccer is a contact sport and they are participating in this league at their own risk. Each team agrees that Center Circle LLC, Bert Ferguson Park (Memphis Parks & Rec), and Faith Lutheran Church, Collierville cannot accept the responsibility or liability for any injuries sustained during this league. Each team will be responsible for their own players and any injuries that may occur.
By initialing here, I have read and agree to the waiver and release printed above:*
Guest Player Fees
Price:
Please note that guest players are allowed a maximum 4 games
Number of Games*
Please enter a number from 1 to 4.
Total Due
$0.00
Please remit payment via cash or check. Checks should be made payable to Center Circle.

Save and Continue Later

Winter Futsal Registration

Please Note:

Liability Waiver and Medical Release