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Player Questionnaire

SAMPLE 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:                         ____________________________________________________________

 

____________________________________________________________

 

BIRTH DATE:                      _______________________________

 

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:        __________________________________

 

_________________________________________________________________________________
HAS THE PLAYER EVER HAD A CONCUSSION (FROM ANY CAUSE)?          Yes           No

 

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 EXPERIENCE:               _________________________________________________

 

__________________________________________________________________________________

 

__________________________________________________________________________________

 

MOST RECENT COACH’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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John Harves
CoachingAmericanSoccer.com®
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