Rockville Soccer Club

Player Registration

Complete the form below to register your player for an RSC program. Fields marked with * are required.

Parent / Guardian Information

First Name *

Last Name *

Relationship to Player

Phone Number *

Email Address *

Street Address

City

State

ZIP Code

Player Information

Player First Name *

Player Last Name *

Player Age *

Date of Birth

Gender

Shirt Size

Program Selection

Select Program *

Emergency Contact

Emergency Contact Name *

Emergency Contact Phone *

Medical Information

Medical Conditions / Medications (optional)

Allergies (optional)

Additional Information

How did you hear about us?

Additional Notes (optional)

Consent & Waiver

I give permission for my player to be photographed or filmed during RSC activities. Photos/videos may be used for club promotional purposes.I acknowledge that participation in soccer activities involves inherent risks. I agree to release Rockville Soccer Club, its coaches, and volunteers from liability for injuries sustained during club activities. *

Our staff will review your registration and follow up within 2–3 business days with next steps and payment information.