Player Questionnaire

You may download this form in any of the following formats:

Administration – SAMPLE Soccer Player Questionnaire

SEASON: _____________________

TEAM

ORGANIZATION

COACH

PLAYER QUESTIONNAIRE

(To be completed with Parent or Guardian)

PLAYER’S NAME:            ____________________________________________________________

ADDRESS:                         ____________________________________________________________

____________________________________________________________

BIRTHDATE:                      _______________________________

CURRENT AGE:                 _______________________________

NICKNAME/CALL BY:      _______________________________

HOME PHONE:                  _______________________________

CALLING RESTRICTIONS, IF ANY:          _________________________________________________

PLAYER’S CELL PHONE: _____________________________

APPROVAL TO CALL PLAYER’S CELL PHONE (Y/N):              _________

PLAYER’S E-MAIL ADDRESS:         ______________________________________________________

APPROVAL TO SEND E-MAIL TO THIS ADDRESS (Y/N):      _________

MOTHER’S NAME:           _____________________________________________________________

MOTHER’S CELL PHONE:               ______________________________________________________

MOTHER’S WORK PHONE:           ______________________________________________________

CALLING RESTRICTIONS, IF ANY:                       ____________________________________________

MOTHER’S HOME E-MAIL ADDRESS:        _______________________________________________

MOTHER’S WORK E-MAIL ADDRESS:        _______________________________________________

E-MAIL RESTRICTIONS, IF ANY: ______________________________________________________

FATHER’S NAME:             ____________________________________________________________

FATHER’S CELL PHONE:                  _____________________________________________________

FATHER’S WORK PHONE:              _____________________________________________________

CALLING RESTRICTIONS, IF ANY:                        ___________________________________________

FATHER’S HOME E-MAIL ADDRESS:          _______________________________________________

FATHER’S WORK E-MAIL ADDRESS:          _______________________________________________

E-MAIL RESTRICTIONS, IF ANY: ______________________________________________________

ANY KNOWN MEDICAL CONDITIONS OR ALLERGIES:        __________________________________

_________________________________________________________________________________

DOES PLAYER NORMALLY WEAR GLASSES OR CONTACT LENSES?                        Yes                        No

PREVIOUSLY REGISTERED?          Yes                        No                   Don’t Know

IF PREVIOUSLY REGISTERED, PLAYER ID NUMBER:             ____________________________________

PLAYER’S SOCCER EXPERICENCE:               _________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

MOST RECENT COACHE’S NAME AND PHONE # ___________________________________________

SOCCER CAMPS ATTENDED, IF ANY:        _________________________________________________

__________________________________________________________________________________

PLAYER’S PREFERRED POSITION, IF ANY:             ___________________________________________

PLAYER’S PREFERRED JERSEY NUMBER, IF ANY:               _______________

FRIENDS WITH TEAMMATES (FIRST AND LAST NAMES):                 _____________________________

__________________________________________________________________________________

POSSIBLE CAR-POOL ARRANGEMENTS WITH:     __________________________________________

AVAILABILITY FOR POSSIBLE TOURNAMENTS: (Please Circle)

MEMORIAL DAY WEEKEND                          Yes                         No

LABOR DAY WEEKEND                                   Yes                         No

COLUMBUS DAY WEEKEND                          Yes                         No

VETERANS’ DAY WEEKEND                           Yes                         No

THANKSGIVING DAY WEEKEND                   Yes                         No

SIGNATURE:       ___________________________________

DATE:    ___________________________________

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