Please fill out and submit the following form. Each player must complete this form. There is no fee for individuals. Teams pay a team fee.

Season and Team
  1. (required)
  2. (required)
  3. (required)
  4. (required)
Name and Contact
  1. (required)
  3. (valid email required)
  4. Are you 30 years or older?
  6. Gender
Emergency Contact
  1. (required)
  2. (required)
If Applicant Legally a Minor
Agreement
  1. I, the above applicant (or the parent or legal guardian of the applicant if a minor), agree that I (and applicant, if a minor) will abide by the rules of the ITHACA UNITED SOCCER CLUB, INC. (IUSC) and its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for IUSC accepting the applicant for its soccer programs and activities (The Programs), I hereby release, discharge and/or otherwise indemnify IUSC and its affiliated organizations and sponsors as well as their employees and associated personnel, including the owners of fields and facilities used for The Programs, against any claim by or on the behalf of the applicant as a result of the applicant's participation in The Programs and/or being transported to or from the same, which transportation I hereby authorize. I, the above applicant (or the parent or legal guardian of the applicant, if a minor), 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 (or that of my dependent, if a minor). Although the youth division of our organization is affiliated with the Federation Internationale de Football Association (FIFA), the adult division holds no such alliance with FIFA and may not necessarily use FIFA certified referees. It is expected that all players are familiar with the rules of soccer and conduct themselves in a sportive and genteel manner.
  2. I agree
 

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