Clone of Spring 2026 Soccer Registration Form

Stilwell Soccer Club (SSC) Registration

FALL 2026
CHILD'S INFORMATION:

Register up to 3 athletes.
Child 1 Name

First NameLast Name
Child 1 Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Male/Female
Child 2 Name

First NameLast Name
Child 2 Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Male/Female
Child 3 Name

First NameLast Name
Child 3 Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Male/Female
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name

First NameLast Name
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Main Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Check if you would like to receive texts about future registrations or events associated with the Stilwell Soccer Club:
E-mail
School
Team/Coach Requests
Parental Support
REGISTRATION PAYMENT
NEW AGE MATRIX (SCHOOL AGE) Cut-off AUGUST 1:

U10 - U16 (One Season)$75.00

Quantity

U6 - U8 (One Season)$55.00

Quantity

Lil Kickers (One Season)$45.00

Quantity

Enter coupon

Total $0.00

By submitting the form, I, as the parent/guardian of the registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may given under whatever conditions are necessary to preserve the life, limb, or well-being of registrant.

By submitting the form, I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the USYSA, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the USYSA accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify the USYSA, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields 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.
Is your Child or Children a member of a Federally Recognized tribe? (Leave blank if you prefer not to answer)
List tribe above. For assistance in applying for grants.
Once you click Submit Form below, you will be taken to a secure PayPal site to complete your payment. SSC is a PayPal Verified merchant. You may pay by credit card or PayPal account.

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Stilwell Soccer Club (SSC) Registration