╨╧рб▒с>■  ,.■   +                                                                                                                                                                                                                                                                                                                                                                                                                                                ье┴M Ё┐А bjbjт=т= "АWАWА       lDDDDDDDX°°°° ,X3╢<<<<<<<<╩╠╠╠@ ╘р╘┤$щ  Ю╪D<<<<<╪PDD<<эPPP<D<D<╩P<╩PP^DD^<0 @XФД┬─Xа°RR^^l03^здмз^PXXDDDD┘NASHOBA UNITED REGISTRATION & CONSENT FORM PlayerТs Last Name _________________________ First Name ________________________________ Address ______________________________________________ M/F ____ D.O.B. _____________ Town _____________________ State ________ ZIP __________ Home Phone ( ) ______________ MotherТs Name: __________________________ FatherТs Name: ______________________________ Email address: -______________________________________________________________________ Medical Problems __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Person to notify in an emergency _______________________________ phone ____________________ Doctor to notify in an emergency _______________________________ phone ____________________ Abide by Rules and Release I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the MYSA, the USYSA (United States Youth Soccer Association), its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the MYSA/USYSA accepting the registrant for its soccer programs and activities (the УProgramsФ), I hereby release, discharge and/or otherwise indemnify the MYSA/USYSA, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the Programs, against any claims by or on the behalf of the registrant as a result of the registrantТs participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize. NAME (print)_____________________________________________________________________ SIGNATURE_____________________________________________ Date_____________________ Consent for Medical Treatment (Minor) As Parent or legal guardian of above named player, I 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 of my dependent. SIGNATURE _______________________________________________Date____________________  +,├рс. : ║ ╛ ╘ ╒ ╓ № ¤ * 3 | } ~ А ¤·°Ї·Ї·°°°э° CJOJQJ5БCJ5БCJCJ+,-ЗЙуыGHбв∙·_`┤∙ШdРРРРРРРРРРРРРР$1$Ifa$$IfЦl4╓╓Ф "Ж" ╓Щ╓     &╓0      Ў╓ ╓ ╓ ╓ 4╓ laЎ$IfА ■┤╡  fg├─┼рўўўўўўўЯpЧ$1$IfX$$IfЦl4╓╓Ф "Ж"    ╓0      Ў╓ ╓ ╓    ╓ 4╓ laЎ$1$If рст- . 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