What information is required by the Club to register my child to play travel soccer in Connecticut?

Parents:

Please collect the required information prior to beginning the online registration process.

Information required by the Club to register a child to play travel soccer in Connecticut.

1. Government-issued proof-of-birth documentation is required:

2. A recent photo is required; recommended: school photo or headshot sized 150px by 200px:

3. Player name is required:

4. Player date-of-birth is required:

5. Player country of birth is required:

6. Player citizenship is required:

7. Parent name is required:

8. Mobile phone is required:

9. Mobile carrier is required:

10. Email address is required:

11. Home address is required:

12. Home city is required:

13. Home state is required:

14. Home zip is required:

15. Emergency contact first name is required:

16. Emergency contact last name is required:

17. Emergency contact primary phone is required:

18. Player medical conditions is required:

19. Player allergies is required:

20. Player's physician is required:

21. Physician phone is required:

22. Medical and/or hospital insurance company is required:

23. Insurance company phone:

24. Policy holder is required:

25. Policy # is required:

26. Group # is required:

27. As always, please email the registrar with any questions or concerns about this or any process, or to have the Club process your registration on your behalf, including uploading to your member account government-issued proof-of-birth or a photo (headshot).