2008 Boys Registration
Tryout Form
Print and bring to the
appropriate tryout
Age Division: □ 18s □ 17s □ 16s □ 15s □
14s
For staff use only
Registration # ______________
Payment received___________
Program Selected Reg JrNtl
Location___________________
PERSONAL INFORMATION
FIRST NAME
LAST NAME
DATE OF BIRTH
AGE
ADDRESS
CITY
ZIPCODE
HOME PHONE
CELL PHONE
PERSONAL EMAIL
PARENT’S NAME
PARENT EMAIL
PARENT OCCUPATION
PARENT BUSINESS PHONE
INJURIES/DISABILITIES
SPECIAL MEDICAL CONDITIONS
NAME OF PERSON FINANCIALLY RESPONSIBLE FOR COSTS (IF DIFFERENT FROM ABOVE)
ADDRESS
CITY
ZIPCODE
HOME PHONE
BUSINESS PHONE
SCHOOL INFORMATION
SCHOOL
GRADE IN SCHOOL
GPA
CLASS RANK
ACT
SAT
COACH’S NAME
COACH’S PHONE AND/OR EMAIL
HEIGHT
WEIGHT
PRIMARY POSITION
SECONDARY POSITION
SPECIAL AWARDS/ACCOMPLISHMENTS
OTHER INFORMATION
YEARS OF CLUB
CLUB NAMES
REASON FOR LEAVING PREVIOUS CLUB(S)
WHAT ARE YOU LOOKING FOR IN POWERHOUSE
OTHER SPORTS/ACTIVITIES YOU PARTICIPATE IN
I WAS REFERRED BY (IF APPLICABLE)