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Bill Sampaio, Director of the PRIDE-FC Soccer and Futsal Club of Massachusetts & Rhode Island invites you to come and Play with Pride!
 
 

:: Register Here to Play with Pride - Pride FC!  


Futsal 2004-2005:  Sign up right here right now for the upcoming 2004-2005 Futsal season.  REGISTER HERE & NOW TO PLAY IN THE November '04 - April '05 Session of Futsal!  Pride FC will compete in the Norfolk County Futsal League in the premier and development divisions. If you are interested in rounding out our squads please submit this form and someone will contact you shortly.


Simply fill out this form online and press SUBMIT!    It's that easy! 

 

Player Registration:

 Name:
Current Team:
Age / Gender:   Age/Group:   Gender:   (Check Age Chart Here)
Grade:   Age:   Gender:   Birth Date
 Address:
City, State Zip: ,  
Home Phone:

Parent  Information:

Father's Name:
Father's Email:
Work Phone:
Cell Phone:
 Mother's Name:
Mother's Email:
Work Phone:
Cell Phone:

Emergency Contact Information:
Contact Name:
 Phone:
Cell Phone:

Medical Conditions:
Known Allergies:
Medical Conditions:

Consent & Release Section:

Consent for Emergency Medical Aid and Medical Treatment
As the registrant or Parent/Legal Guardian of the above named registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dental Medicine. This care may be given under whatever conditions are necessary to preserve life, limb, or well-being as deemed advisable in the event of an accident or illness during the soccer related activities in which we are voluntarily participating.  I , the participant or parent/guardian of a minor registrant, agree that the registrant and I will abide by the rules of the league, its affiliates and sponsors. Recognizing the possibility of physical injury associated with Soccer & Futsal and in consideration for the League accepting the registrant for its Futsal  and Soccer programs and activities (the "Programs"), I hereby release, discharge, and/or indemnify the League, its affiliated organizations (if any) and sponsors, their employees and associated personnel, including the owners of gymnasiums and facilities utilized for the Programs, against any claim by or on 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. Further, I hereby acknowledge that participation in athletic competitions, camps, and/or clinics carries with it certain potential hazards. In consideration for League accepting the registrant for its program,  I further release, discharge and/or indemnify the diocesan schools, its officers, directors and employees, any coaches, assistant coaches and referees, the schools in which any such athletic activities are being physically conducted, the league with which I am affiliated, the organization permitting theCougar Pride! institution/facility, and the institution/facility at which this activity is being conducted, against any claim by or on behalf of the registrant as a result of registrant's participation in the Futsal and Soccer programs.
Parent / Legal Guardian Name:
Parent / Legal Guardian Signature:  
(if signing up online please type in name and last 4 digits of your social security number)
 

Payment Area:
I have paid for a player registration for the 2004-2005 Futsal session w/ Pride FC
I wish to pay by check and will submit it by mail
 (Please make check payable to Pride FC & mail to 55 Glendale St Tiverton, RI 02878)

 

 
   
 

PRIDE - FC "si se puedo"  Come play with Pride!