MSYSA ODP Tryout Form
Fill out form below and press "Submit." All Caps NOT Accepted. Proper Punctuation Required.
Click Here to Read About Tryouts
Click Here to Read About 101 Camps
First Name:
Last Name:
Street Address:
City:
State:
Michigan
Ohio
Indiana
Illinois
Wisconsin
Zip:
Phone Number:
Email Address:
Date of Birth:
Month
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05
06
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08
09
10
11
12
/
Day
01
02
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04
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Year
1994
1995
1996
1997
1998
1999
2000
2001
Club Team Name:
High School Graduation Year:
2011
2012
2013
2014
2015
2016
2017
2018
2018
2019
2020
2021
GPA:
U.S. Citizenship?
Yes
No
Position:
Field Player
Goalkeeper
Both
Registering For:
Boys Tryout
Girls Tryout
2000 Boys 101 Camp
2000 Girls 101 Camp
2001 Boys 101 Camp
2001 Girls 101 Camp
Age Group (based on birth year - for Tryouts only):
None
1999 Boys
1998 Boys
1997 Boys
1996 Boys
1995 Boys
1994 Boys
1999 Girls
1998 Girls
1997 Girls
1996 Girls
1995 Girls
1994 Girls
For 101 Tryout Only choose one site:
West (Grand Rapids Area)
Metro North (Oxford)
Metro Central (Northville), and
Central North (Mason)
Is Player Registered with a MSYSA Sponsored Team?
Yes
No
If not, $10 will be added to your Tryout Registration Fee or Tryout Camp Registration Fee for insurance. Any questions regarding insurance should be directed to MSYSA at 734-459-6220.
Tryout Registration Fee is normally $100 (if registered by June 30, 2010) or $125 (if registered after June 30, 2010). 101 ID Camp Registration Fee is $80.00 (if registered by June 30, 2010) or $100 (if registered after June 30, 2010).
Method of Payment:
Credit Card
Check
If you selected the credit card option, please fill out the credit card payment information below.
Name on Credit Card:
Credit Card Type:
Visa
MasterCard
Credit Card Number:
Exp. Date:
Month
01
02
03
04
05
06
07
08
09
10
11
12
/
Year
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Cardholder's Address:
Cardholder's Zip Code:
A parent or legal guardian must agree to the following statement:
I hereby authorize the Michigan Olympic Development Program to provide emergency medical treatment for my son/daughter should an injury occur during try-outs or subsequent practices. My son/daughter has had a recent physical examination and is physically capable of participating in try-outs. I hereby release, discharge, and/or otherwise indemnify the MSYSA, its affiliated organizations and sponsors, their employees and associated personnel, including all volunteers and the owners of fields and facilities utilized by the program, against any claim by or on behalf of the registrant as a result of the registrant's participation in the program.
Please check over your information thoroughly before submitting.
Please click the Submit button ONLY ONCE.
Sometimes, it takes a few seconds for the form to be processed. Thank you.
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