CNYJSA PLAYER INFORMATION FORM – INVICTUS FC PROFESSIONAL SOCCER DEVELOPMENT

CNYJSA Player Information Form

Player's First Name: *

Player's Last Name: *

Player's Date of Birth: *

Parent/Guardian Emergency/Primary Cell Phone Number: *

Parent/Guardian Primary Email Address: *

Please upload the player's passport style headshot picture: *

Please upload a copy of player's birth certificate: *

Home Street Address: *

Country

City

State

Zip code

*Note: After hitting the Submit Information button below, please allow time for your files to upload. Do not refresh the page or close the window until you receive a confirmation message.