Charlotte Sports Center Youth Application

Player Information
First Name*	Last Name*		Gender*

Address*			D.O.B.(mm/dd/yyyy)*

City*	State*	Zip Code*	Primary Phone*

Email Address*			Secondary Phone

Parent Name*		How did you hear about us?*

Sport or Activity Information
Select Sport or Activity*	Select Season*	Are You a Goalie

Notes or Medical Conditions
Enter any Notes or Medical Information Here.

Payment Information

Full payment is required for all youth programs. Once your Registration Form has been received and processed (within 24-48 hours), you will receive an email with instructions to log into our secure and encrypted online MySAM system to process your payment. Payment must be made within 24 hours of receiving your registration confirmation. A Player's Card annual registration fee will automatically be added to your shopping cart when you process your payment if you do not have one.

Waiver of Liability

I (self/parent/guardian), desire for my (self/son/daughter) to participate in one of Charlotte Sports Center, LLC's or Sports Connection, LLC's sports leagues or activities. I understand that adult sports involve physical contact between players and I assume the risks associated with (my/his/her) participation. (I/my child) (have/has) no known medical conditions which prohibit participation in this sport. I agree to hold harmless and release Charlotte Sports Center, LLC, Sports Connection, LLC and their agents and sponsors from legal liability resulting from any injuries sustained during participation in these activities. I understand Charlotte Sports Center, LLC and Sports Connection, LLC cannot be responsible for loss or damage to (my/my child's) personal possessions. You may use (my/my child's) photograph in future promotions.

Click Here to Read Complete Release and Waiver Agreement

I have read and agree to the Complete Release and Waiver Agreement.

If a confirmation page does not display after submitting, REFRESH your browser and try again or call to register by phone 704-597-7311. Thank You!