5 on 5 Registration Form Athlete's Name * First Name Last Name Parent/Guardian's Name * First Name Last Name Email * Phone * (###) ### #### Athlete's Date of Birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Insurance Carrier * Insurance Group Number * Insurance Policy Number * Athlete's Weight * Athlete's Height * Athlete's Grade * Athlete's Age * Teams Previously Played For (N/A if not applicable) * Positions * T-Shirt Size * Youth Small Youth Medium Youth Large Youth XL Adult Small Adult Medium Adult Large Adult XL Adult 2XL Adult 3XL I have read and either printed out or downloaded the waiver form and will be emailing it or providing the physical filled out copy to complete registration. * Waiver Form must be signed and completed in order to complete registration. I will bring a hard copy of the completed waiver form I will email a copy of the completed waiver form Thank you for registering for 5 on 5 with AIA! We will contact you shortly to confirm your registration.
