Worcester Field Hockey Online Signup

Register online for the Spring 2020 session!

Worcester Field Hockey Online Signup Form

Please enter the athlete's information below.

Cost: $60 Grades 1-8 || $40 Grades PreK-K --- Family Cap $120 --- Scholarships and Financial Aid available

You will be directed to a payment page via Paypal after this form.

All players need to have a stick, shin guards and a mouth guard. Sticks are available to borrow.

4 sessions of skills and games in Commerce Bank Field at Foley Stadium
Sundays starting Sunday, April 26th (May 3rd session will be held at 4 PM - 5:30 PM (Pre-K 4-5) due to field availability)

All other sessions are 10am-11:30am (Pre K-K 10am-11am)

Contact Email Address *

Session *

School Attended *

First Name *

Last Name *

Grade (in September) *

Date of Birth (MM/DD/YYYY) ex. (10/25/1999) *

Mailing Street Address *

PO Box/Apartment #

City *

State (2 Letters) *

Zip Code *

Contact Phone Number (10 digits, no punctuation) *
( ) - -

Physician Contact Name *

Physician Contact Phone Number (10 digits, no punctuation) *
( ) - -

Please check the following box if you have played field hockey before:

I have been enrolled in field hockey before

If Yes, Where?

Dietary or Medical Concerns

Scroll Below for Full Consent to Play and Consent for Medical Release

CONSENT TO PLAY AND CONSENT FOR MEDICAL RELEASE:

I, the parent/guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of the league, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associate with field hockey and in consideration for the league accepting the registrant for its program and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify Worcester Field Hockey, its affiliated organizations, sponsors and their employees and associated personnel, including the owner of the fields and facilities utilized for the programs, against any claim by or on the 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.

As parent or Legal Guardian of the above-named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medical or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well being of my dependent.

Click here to download a PDF of the Terms and Conditions

Please check the following boxes if you agree to proceed: *

I Agree to abide by the Terms and Conditions posted on this page and understand that I am responsible for paying registration fees I certify that I am over the age of 18 or an authorized person to enroll a participant under the age of 18 and acknowledge that the Worcester Public Schools is not responsible for, or connected with, any aspect of this program and participation in this program is the sole decision and responsibility of the parent/guardian.

Parent/Guardian Name (eSignature) *