Parent/Admin Name and Relation
Address, Phone Numbers and Email
New or Returning Player
Player Name
Gender, DOB, Number of Seasons Previously Played
School Name, Grade Next Fall, Player Level
Emergency Contact
Medical Problems, Physical Limitations
Note: You do not need to complete the uniform size section
PLEASE SIGN AND DATE THE FORM
Remember that if you are new to BSA, you must bring an "original" birth certificate for age verification (not a copy).
For questions, contact:
Mary Martinez
714-256-1382
(Mailing Address) (Drop-off Address, BSA box on porch)
Brea Soccer Association 101 S. Flower Ave.
Attn: Registrar Brea
PO Box 573
Brea, CA 92822