Player Name: Last First

Gender: M F Birthdate: MM/DD/YYYY

Address: Street

City State TX Zip

Elementary School

Parent/Guardian Contact:

Mom Cell Mom Email

Dad Cell Dad Email

Other Cell Other Email

Player Level: (Uprising or National)

Player Experience: First time Uprising participant: Yes No If Yes: How many season at Uprising:

Player agreement – Uprising League Agreement:
1. I accept all responsibility for any injury that might occur at practice or games
2. Games and training that are cancelled will not be made up.
3. I promise to pick up any items that I brought to training or games
4. I promise not to confront coaches, parents or players regarding game or training issues.